October 2015

Risk and Protective Factors and Initiation of Substance Use:
Results from the 2014 National Survey on Drug Use and Health

Authors

SAMHSA: Rachel Lipari; RTI International: Larry A. Kroutil and Michael R. Pemberton

Abstract

Background. Whether someone engages in substance use is often related to exposure to factors that are typically associated with an increased likelihood of substance use (i.e., risk factors) or factors that are typically associated with a decreased likelihood of substance use (i.e., protective factors). Efforts to prevent substance use generally aim to reduce the influence of risk factors and to enhance the effectiveness of protective factors. One major goal of substance use prevention programs is to prevent or delay the initiation of substance use (i.e., first use).

Methods. This report presents data from the 2002 through 2014 National Surveys on Drug Use and Health (NSDUHs) for trends in people's perceptions of great risk of harm associated with the use of cigarettes, alcohol, and specific illicit drugs and the perceived availability of substances. The data are presented for the population aged 12 years old or older and for specific age groups. Trends in perceived great risk of harm associated with the use of specific substances (i.e., marijuana, alcohol, and cigarettes) were compared with trends in the use of these substances in the past 30 days. The report also includes trends for measures that are specific to youths aged 12 to 17, such as perceptions about parents strongly disapproving of youth substance use. Finally, this report includes trends in the estimated numbers of individuals who initiated substance use in the past year and the average age at first use among people who initiated use in the past year (i.e., past year initiates). The report focuses on long-term trends by comparing estimates from the 2014 NSDUH with NSDUH estimates in 2002 to 2013. Statistically significant differences are noted between estimates in 2014 and those in prior years.

Results. People aged 12 or older were less likely to perceive great risk of harm from monthly or weekly marijuana use in 2014 than in 2002 to 2013. This pattern was also observed for youths aged 12 to 17, young adults aged 18 to 25, and adults aged 26 or older. There also were declines in the percentages of people aged 12 or older who perceived that the use of cocaine or LSD was risky. Nevertheless, in 2014, the majority of people aged 12 or older perceived great risk of harm from the use of cocaine or LSD. The percentage of people aged 12 or older in 2014 who perceived great risk from trying heroin (83.1 percent) was somewhat higher than the percentages in 2002 to 2013. Percentages of people aged 12 or older in 2014 who perceived great risk from binge alcohol use were lower than the percentages in most years from 2002 to 2013. Percentages of people aged 12 or older who perceived great risk from smoking one or more packs of cigarettes a day were similar between 2009 and 2014.

Consistent with the decrease in the perceptions of marijuana use being risky, past month marijuana use increased over time for the population aged 12 or older and for adults aged 26 or older; however, this pattern did not hold for youths or young adults. Changes in binge alcohol use and cigarette use were not as closely related to changes in risk perceptions for binge alcohol use and smoking a pack or more of cigarettes a day as was the case with relationships for marijuana.

The numbers of people who initiated use of many substances in the past year generally remained the same in most recent years. For example, the number of recent marijuana initiates aged 12 or older in 2014 (2.6 million) was greater than the numbers in 2002 to 2008, but it was similar to the numbers in 2009 to 2013. The number of people aged 12 or older in 2014 who were recent initiates for the nonmedical use of pain relievers (1.4 million) was second only to the number of marijuana initiates for the categories of illicit drugs in NSDUH. However, the number of new initiates for the nonmedical use of pain relievers in 2014 was lower than the numbers in 2002 to 2012, which ranged from 1.9 million to 2.5 million new users each year. The numbers of adolescents in 2014 who recently initiated use of alcohol or cigarettes were lower than the numbers in most years from 2002 to 2012, but they were similar to the numbers of initiates in 2013.

Conclusions. Findings from NSDUH on trends in risk perceptions and other issues related to risk and protective factors for substance use are useful to the Substance Abuse and Mental Health Services Administration for gauging the overall effectiveness of prevention efforts on a broad national level and for tracking factors that may signal changes in the extent of substance use in the population. NSDUH data on trends in the initiation of substance use also can be useful to policymakers and program planners for anticipating future needs for services and can help provide information on the long-term effectiveness of prevention programs as a whole. However, these NSDUH data are not intended to be used to evaluate the effectiveness of individual prevention programs. Also, where associations exist between a perceived low risk of harm from substance use and actual use, it is not possible to determine from NSDUH data whether the perception came first and influenced an individual's likelihood to engage in substance use or if substance use came first and influenced an individual's risk perceptions.




Introduction


Substance use and abuse are major public health problems in the United States. Nevertheless, many individuals do not engage in substance use. Whether someone engages in substance use depends on the number and types of risk factors that are typically associated with an increased likelihood of substance use (e.g., perception of low risk of harm from using a substance, easy availability of substances) and protective factors that are typically associated with a decreased likelihood of substance use (e.g., exposure to prevention messages).1 Risk and protective factors include variables that reflect different domains of influence, including the individual, family, peer, school, community, and society.2,3,4 Interventions to prevent substance use are commonly designed to reduce the influence of risk factors and enhance the effectiveness of protective factors. One major goal of substance use prevention programs is to prevent or delay the initiation (first use) of substances. In particular, multiple studies have found associations between early initiation of alcohol or illicit drug use (e.g., in adolescence) and an increased likelihood of developing substance use disorders (SUDs), although there are competing explanations for the underlying reasons for the association.5,6,7 Information on trends in initiation also can provide information on the long-term effectiveness of prevention programs as a whole (i.e., but not the effectiveness of individual programs).

The National Survey on Drug Use and Health (NSDUH) provides information on risk and protective factors that may affect the likelihood that individuals will engage in substance use. The survey also collects information on current (i.e., past 30 day) use of illicit drugs, alcohol, and tobacco, as well as information on the age at first use of these substances.

This report contains the first release of 2014 NSDUH estimates on trends in substance use prevention issues and the initiation of substance use in the United States. Prevention issues include the perceived risk from substance use and the perceived availability of substances. Estimates for initiation include the number of individuals who initiated substance use in the past year and the average age at first use among people who initiated use in the past year. Comprehensive 2014 NSDUH detailed tables that show additional substance use-related outcomes, including data for various subpopulations covered in NSDUH, are available separately at https://www.samhsa.gov/data/.



Survey Background


NSDUH is an annual survey of the civilian, noninstitutionalized population of the United States aged 12 years old or older.8 The survey is sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services (HHS). The survey covers residents of households and individuals in noninstitutional group quarters (e.g., shelters, boarding houses, college dormitories, migratory workers' camps, halfway houses). The survey excludes people with no fixed address (e.g., homeless people not in shelters), military personnel on active duty, and residents of institutional group quarters, such as jails, nursing homes, mental institutions, and long-term hospitals.

NSDUH employs a stratified multistage area probability sample that is designed to be representative of both the nation as a whole and for each of the 50 states and the District of Columbia. The 2014 NSDUH target sample size of 67,500 interviews was distributed across three age groups, with 25 percent allocated to adolescents aged 12 to 17, 25 percent allocated to young adults aged 18 to 25, and 50 percent allocated to adults aged 26 or older. In 2002 through 2013, the NSDUH sample was allocated equally across these three age groups and had the same total target sample size per year as in 2014.9

NSDUH is a face-to-face household interview survey that is conducted in two phases: the screening phase and the interview phase. The interviewer conducts a screening of the eligible household with an adult resident (aged 18 or older) in order to determine whether zero, one, or two residents aged 12 or older should be selected for the interview.10 NSDUH collects data using audio computer-assisted self-interviewing (ACASI), in which respondents read or listen to the questions on headphones and then enter their answers directly on the NSDUH laptop computer. ACASI is designed to encourage accurate reporting of information by providing respondents with a highly private and confidential mode for responding to questions about illicit drug use, mental health, and other sensitive behaviors. NSDUH also uses computer-assisted personal interviewing (CAPI), in which interviewers read less sensitive questions to respondents and enter the respondents' answers on the laptop.

In 2014, screening was completed at 127,605 addresses, and 67,901 completed interviews were obtained, including 17,046 interviews from adolescents aged 12 to 17 and 50,855 interviews from adults aged 18 or older. Weighted response rates for household screening and for interviewing were 81.9 and 71.2 percent, respectively, for an overall response rate of 58.3 percent for people aged 12 or older. Weighted interview response rates were 80.0 percent for adolescents and 70.3 percent for adults.11 Further details about the 2014 NSDUH design and methods can be found on the web at https://www.samhsa.gov/data/.12



Data Presentation and Interpretation


Most estimates in this report are presented separately for individuals aged 12 or older, adolescents aged 12 to 17, and adults aged 18 or older. However, some estimates are presented only for youths aged 12 to 17 because questions such as perceptions of parental disapproval of substance use, youths' disapproval of peers' substance use, and exposure to substance use prevention messages were asked only of people in that age group.

All estimates (e.g., percentages and numbers) presented in the report are derived from the NSDUH survey data that are subject to sampling errors. The estimates have met the criteria for statistical reliability. Estimates that do not meet these criteria for reliability have been suppressed and are not shown.13 Except for the section on the initiation of substance use, trend analyses in this report focus on percentages because the percentages take into account any changes in the size of the total population and facilitate the comparison of estimates across years.14 This report focuses on long-term trends by comparing estimates in 2014 with estimates in each of the years from 2002 to 2013. Statistical tests also have been conducted for comparisons that appear in the text of the report. Statistically significant differences are described using terms such as "higher," "lower," "increased," or "decreased." Statements use terms such as "similar," "remained steady," or "stable" when a difference is not statistically significant. Analyses of long-term trends in this report summarize whether the 2014 estimates are different from or similar to estimates in most previous years,15 while minimizing discussion of anomalous differences between any 2 years that can occur due to these estimates being based on samples.16 Graphics and tables contain estimates that support the statements in this report, and supplemental tables of estimates (including standard errors) are included in Appendix A.



Perceived Risk from Substance Use


One factor that can influence whether individuals will use tobacco, alcohol, or illicit drugs is the extent to which they believe these substances might cause them harm. NSDUH respondents were asked how much they thought people risk harming themselves physically and in other ways when they use various substances in certain amounts or frequencies. Response choices for these items were "great risk," "moderate risk," "slight risk," or "no risk." For many of these substances, respondents were asked about their perceived risk of harm from using substances once a month (i.e., monthly use) or once or twice a week (i.e., weekly use).

Figure 1 presents the percentages of people aged 12 or older in 2014 who perceived great risk from each of the substance use measures. However, caution should be used when comparing perceptions of risk across certain substances because of variations in the content of questions.17 Comparing risk perceptions across substances becomes more straightforward when the quantity or frequency of use is similar. For example, respondents are asked about the perceived risk of harm associated with any use of the following drugs once or twice a week: marijuana, cocaine, heroin, and LSD. Therefore, it is appropriate to note that in 2014, the percentage of individuals aged 12 or older who perceived great risk in using these drugs once or twice a week was higher for heroin (93.3 percent) than for cocaine (86.3 percent), LSD (83.9 percent), or marijuana (34.3 percent).


Figure 1. Perceived Great Risk from Substance Use among People Aged 12 or Older: Percentages, 2014
Figure 1     D

Perceived Risk from Marijuana Use

In 2014, 26.5 percent of individuals aged 12 or older perceived great risk in smoking marijuana once a month (i.e., monthly use), and 34.3 percent perceived great risk in smoking marijuana once or twice a week (i.e., weekly use) (Figure 1). Perceptions of risk varied by age, with young adults aged 18 to 25 being less likely than adolescents aged 12 to 17 or adults aged 26 or older to perceive great risk from smoking marijuana on either a monthly basis (Figure 2) or a weekly basis (Table 1).


Figure 2. Perceived Great Risk from Smoking Marijuana Once a Month among People Aged 12 or Older, by Age Group: Percentages, 2002-2014
Figure 2     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 2 Table. Perceived Great Risk from Smoking Marijuana Once a Month among People Aged 12 or Older, by Age Group: Percentages, 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   38.3+   39.6+   39.7+   38.3+   39.3+   38.3+   36.9+   34.4+   32.5+   31.9+   30.8+   28.2+ 26.5
12 to 17   32.4+   34.9+   35.0+   34.0+   34.6+   34.4+   33.4+   30.3+   29.6+   27.6+   26.5+   24.2+ 22.9
18 to 25   23.5+   24.8+   25.6+   24.4+   24.4+   24.7+   22.7+   19.9+   18.5+   18.0+   16.7+   14.9+ 13.5
26 or Older   41.7+   42.9+   42.9+   41.3+   42.5+   41.1+   39.8+   37.5+   35.4+   34.9+   33.8+   31.0+ 29.2

Table 1. Perceived Great Risk from Smoking Marijuana Once or Twice a Week among People Aged 12 or Older, by Age Group: Percentages, 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   51.3+   52.8+   52.4+   51.5+   51.2+   50.9+   48.7+   45.7+   43.2+   42.3+   40.3+   37.1+ 34.3
12 to 17   51.5+   54.4+   54.7+   55.0+   54.2+   54.6+   52.8+   49.0+   47.2+   44.8+   43.6+   39.5+ 37.4
18 to 25   35.5+   36.8+   38.1+   37.0+   35.9+   35.8+   33.1+   28.6+   27.0+   25.6+   23.5+   21.0+ 18.3
26 or Older   54.1+   55.4+   54.7+   53.6+   53.5+   53.0+   50.9+   48.2+   45.6+   44.9+   42.9+   39.6+ 36.6

Compared with prior years, people aged 12 or older were less likely to believe in 2014 that marijuana use is risky. Specifically, the percentages of the population aged 12 or older in 2014 who perceived great risk from either monthly or weekly marijuana use were lower than the percentages in all the years from 2002 to 2013.

Aged 12 to 17

In 2014, about 1 in 5 adolescents perceived great risk from monthly marijuana use (22.9 percent) (Figure 2), and 37.4 percent perceived great risk from weekly marijuana use (Table 1). The percentages of adolescents who perceived great risk from monthly or weekly marijuana use were lower in 2014 than in any year from 2002 to 2013. In 2002 to 2008, for example, more than half of adolescents perceived great risk from weekly marijuana use.

Aged 18 to 25

In 2014, 13.5 percent of young adults aged 18 to 25 perceived great risk from monthly marijuana use (Figure 2), and 18.3 percent perceived great risk from weekly marijuana use (Table 1). These percentages in 2014 among young adults were lower than in 2002 to 2013.

Aged 26 or Older

Among adults aged 26 or older, 29.2 percent indicated there was a great risk from smoking marijuana monthly (Figure 2), and about 1 out of 3 indicated there was a great risk from smoking marijuana weekly (36.6 percent) (Table 1). As with the other age groups, these 2014 percentages were lower than the percentages in 2002 to 2013. As was the case for youths aged 12 to 17, more than half of adults aged 26 or older in 2002 to 2008 perceived great risk from weekly use of marijuana.

Perceived Risk from Cocaine Use

In 2014, most individuals aged 12 or older perceived great risk from using cocaine either once a month or once or twice a week (68.6 and 86.3 percent, respectively) (Figure 3 and Table 2). Perceptions of risk varied by age, with adolescents aged 12 to 17 being less likely than young adults aged 18 to 25 or adults aged 26 or older to perceive great risk from using cocaine either monthly or weekly. However, only 0.2 percent of adolescents in 2014 used cocaine in the past month; in comparison, 1.4 percent of young adults used cocaine in the past month (Table A.5B in Appendix A). Therefore, the lower likelihood of adolescents than adults to perceive great risk of harm from cocaine use may reflect a general lack of knowledge about cocaine among adolescents.


Figure 3. Perceived Great Risk from Using Cocaine Once a Month among People Aged 12 or Older, by Age Group: Percentages, 2002-2014
Figure 3     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 3 Table. Perceived Great Risk from Using Cocaine Once a Month among People Aged 12 or Older, by Age Group: Percentages, 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   71.5+   71.0+   70.8+   71.1+   71.1+   71.5+   70.1+   70.4+   70.2+ 69.4   70.5+ 69.2 68.6
12 to 17 50.5   51.4+ 49.6 48.8 49.0 49.6 49.4 49.2 49.1   48.1+ 50.4 49.3 49.8
18 to 25 64.1 63.6 62.6 62.4 62.5 63.2 61.8   60.9+ 61.9 62.0 63.5 62.8 62.9
26 or Older   75.7+   75.0+   75.2+   75.7+   75.6+   75.8+   74.2+   74.7+   74.3+   73.4+   74.2+ 72.8 71.9

Table 2. Perceived Great Risk from Using Cocaine Once or Twice a Week among People Aged 12 or Older, by Age Group: Percentages, 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   89.4+   89.0+   89.0+   89.4+   88.8+   89.1+   88.6+   87.9+   88.0+   87.5+   87.9+   87.3+ 86.3
12 to 17   79.8+   80.7+   79.8+   79.9+   79.2+   78.9+   79.1+   78.4+   78.3+ 78.1   78.9+   78.4+ 77.2
18 to 25   87.2+   86.6+   85.9+   85.8+   85.7+   85.8+   85.7+ 84.2 84.5 84.8   85.5+ 84.3 84.4
26 or Older   91.1+   90.6+   90.8+   91.3+   90.7+   91.0+   90.3+   89.7+   89.8+   89.2+   89.4+   89.0+ 87.8

The percentages of people aged 12 or older in 2014 who perceived great risk from either monthly or weekly cocaine use were lower than the percentages in most previous years for monthly use (Figure 3) and in all previous years for weekly use (Table 2). However, these declines were relatively modest. At its peak in 2002 and 2007, for example, 71.5 percent of people aged 12 or older perceived great risk of harm from monthly cocaine use. In 2014, more than two thirds of people aged 12 or older perceived great risk from monthly cocaine use, and more than four fifths perceived weekly use to be risky.

Aged 12 to 17

The percentage of adolescents aged 12 to 17 in 2014 who perceived great risk from monthly cocaine use (49.8 percent) was similar to the percentages in most years from 2002 to 2013 (Figure 3). In contrast, the percentage of adolescents perceiving great risk from weekly cocaine use in 2014 was lower than the percentages in most years from 2002 to 2013 (Table 2). Nevertheless, more than 3 out of 4 adolescents in 2014 (77.2 percent) perceived great risk of harm from weekly cocaine use.

Aged 18 to 25

In 2014, the percentage of young adults aged 18 to 25 who perceived great risk from monthly cocaine use (62.9 percent) was similar to the percentages in most years from 2002 to 2013 (Figure 3). The percentage of young adults perceiving great risk from weekly cocaine use in 2014 was similar to the percentages in most years between 2009 and 2013 (Table 2). Although the 2014 percentage for perceived great risk from weekly cocaine use was lower than the percentages from 2002 to 2008, the majority of young adults in 2014 (84.4 percent) perceived great risk of harm from weekly use.

Aged 26 or Older

In 2014, the percentage of adults aged 26 or older who indicated there was a great risk in using cocaine monthly (71.9 percent) was lower than the percentages in 2002 through 2012, but it was similar to the percentage in 2013 (Figure 3). The 2014 percentage of adults aged 26 or older who perceived great risk from weekly cocaine use remained high (87.8 percent), but it was lower than the percentages in 2002 to 2013 (Table 2).

Perceived Risk from Heroin Use

In 2014, most individuals aged 12 or older perceived great risk in trying heroin once or twice (83.1 percent) (Figure 4) or from using heroin on a weekly basis (93.3 percent) (Table 3). Perceptions of risk varied widely by age group, with adolescents aged 12 to 17 being less likely than young adults aged 18 to 25 or adults aged 26 or older to perceive great risk from using heroin once or twice or on a weekly basis (Figure 4 and Table 3). In 2014, however, only 0.1 percent of adolescents used heroin in the past year (Table A.5B in Appendix A). Because heroin use among adolescents is relatively uncommon, the lower likelihood of adolescents than adults to perceive great risk of harm from heroin use may be attributable to a general lack of knowledge about heroin among adolescents.


Figure 4. Perceived Great Risk from Trying Heroin Once or Twice among People Aged 12 or Older, by Age Group: Percentages, 2002-2014
Figure 4     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 4 Table. Perceived Great Risk from Trying Heroin Once or Twice among People Aged 12 or Older, by Age Group: Percentages, 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   82.4+   82.2+   81.3+   81.8+   82.2+   81.9+   81.8+   81.9+   81.8+   82.0+ 82.6   82.2+ 83.1
12 to 17 58.5 58.8   57.0+   56.5+   57.2+   56.9+   57.4+   56.7+   57.4+   56.6+   57.3+ 58.2 59.2
18 to 25   78.0+   77.5+   76.9+   76.9+   77.9+   78.1+   77.2+   76.8+   76.8+   78.0+   79.0+ 79.2 80.2
26 or Older 86.5 86.2   85.3+ 86.1 86.3 85.9 85.8 85.9 85.7 85.9 86.3 85.7 86.5

Table 3. Perceived Great Risk from Using Heroin Once or Twice a Week among People Aged 12 or Older, by Age Group: Percentages, 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   93.9+   93.9+   93.7+   93.8+   93.8+   93.9+ 93.6 93.6 93.4 93.4 93.4 93.3 93.3
12 to 17   82.5+   82.6+   81.4+   81.8+   81.2+ 81.0   81.3+ 80.9 80.4 79.7 80.0 79.8 79.9
18 to 25 93.6 93.5 93.3 93.7 93.6 93.5 92.9   92.8+   92.6+   92.6+ 93.2 92.9 93.5
26 or Older   95.5+   95.5+   95.5+   95.5+   95.5+   95.6+ 95.3   95.4+ 95.2 95.2 95.1 95.1 94.8

For the population aged 12 or older, the percentage of people in 2014 who perceived great risk from trying heroin (83.1 percent) was somewhat higher than the percentages in 2002 to 2013 (Figure 4). There were minimal changes from 2008 to 2014 in the percentages of people aged 12 or older who perceived great risk from weekly heroin use (Table 3). In each year between 2002 and 2014, more than 90 percent of people aged 12 or older perceived great risk from weekly heroin use.

Aged 12 to 17

In 2014, 59.2 percent of adolescents aged 12 to 17 perceived great risk from trying heroin (Figure 4), and 79.9 percent perceived great risk from weekly heroin use (Table 3). The percentage of adolescents in 2014 who perceived great risk from trying heroin was higher than the percentages in 2004 to 2012, but it was similar to the percentage in 2013. More than half of adolescents in each year between 2002 and 2014 perceived great risk from trying heroin.

The percentage of adolescents in 2014 who perceived great risk from weekly heroin use was similar to the percentages in 2009 to 2013, but it was lower than the percentages in most years from 2002 to 2008. Nevertheless, about four fifths or more of adolescents in each year between 2002 and 2014 perceived great risk from weekly heroin use.

Aged 18 to 25

The percentage of young adults aged 18 to 25 who perceived great risk from trying heroin was higher in 2014 (80.2 percent) than in 2002 through 2012 (ranging from 76.8 to 79.0 percent) (Figure 4). The percentage of young adults who perceived great risk from weekly heroin use in 2014 (93.5 percent) was similar to the percentages in most years since 2002 (Table 3). However, in a 3-year period from 2009 to 2011, the percentages were slightly lower than in 2014.

Aged 26 or Older

In general, the percentage of adults aged 26 or older in 2014 who indicated there was a great risk from trying heroin was stable from 2002 to 2014 (Figure 4). The percentage of adults aged 26 or older who perceived great risk from weekly heroin use in 2014 (94.8 percent) was similar to the percentages in 2010 to 2013, but it was lower than the percentages in most years from 2002 to 2009 (Table 3). Nevertheless, more than 90 percent of adults aged 26 or older in each year between 2002 and 2014 perceived great risk from weekly heroin use.

Perceived Risk from LSD Use

In 2014, most individuals aged 12 or older perceived great risk from trying LSD once or twice (68.0 percent) (Figure 5) or from using LSD on a weekly basis (83.9 percent) (Table 4). Perceptions of risk varied by age, with adolescents aged 12 to 17 being less likely than young adults aged 18 to 25 or adults aged 26 or older to perceive great risk from trying LSD once or twice or using it on a weekly basis (Figure 5 and Table 4). As was the case with the perceived risk from cocaine use and heroin use, this finding for LSD may be attributable to adolescents' general lack of knowledge about LSD.


Figure 5. Perceived Great Risk from Trying LSD Once or Twice among People Aged 12 or Older, by Age Group: Percentages, 2002-2014
Figure 5     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 5 Table. Perceived Great Risk from Trying LSD Once or Twice among People Aged 12 or Older, by Age Group: Percentages, 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   73.7+   73.4+   72.1+   72.8+   72.3+   72.2+   70.8+   71.0+   70.1+   70.3+   70.1+ 68.7 68.0
12 to 17   52.6+   53.4+   52.6+   51.7+   51.6+   51.0+   50.2+   48.1+   47.8+ 47.0 47.2 47.1 46.2
18 to 25   62.4+   63.0+   62.6+   62.1+   63.3+   63.5+   61.2+   60.0+   59.3+   60.1+   59.1+   57.9+ 56.4
26 or Older   78.5+   77.9+   76.4+   77.5+   76.6+   76.4+   75.0+   75.7+   74.6+   74.9+   74.8+ 73.1 72.5

Table 4. Perceived Great Risk from Using LSD Once or Twice a Week among People Aged 12 or Older, by Age Group: Percentages, 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   88.8+   88.7+   88.8+   88.8+   88.5+   88.5+   87.7+   86.9+   86.3+   86.1+   85.9+   85.0+ 83.9
12 to 17   76.2+   76.9+   76.4+   76.1+   74.7+   74.1+   73.8+   71.7+   71.3+   70.4+   70.6+   69.7+ 68.4
18 to 25   84.8+   85.3+   85.7+   85.5+   84.9+   84.9+   83.3+   81.5+   80.6+   80.4+   80.0+ 77.5 77.3
26 or Older   91.2+   90.9+   91.0+   91.1+   91.0+   91.0+   90.2+   89.7+   89.1+   89.0+   88.7+   88.1+ 86.8

The percentages of individuals aged 12 or older in 2014 who perceived great risk from trying LSD once or twice or from using LSD on a weekly basis were lower than the percentages in most years from 2002 to 2013 for trying LSD (Figure 5) and in each prior year for weekly use (Table 4). The percentages of people aged 12 or older who perceived great risk from trying LSD once or twice ranged from 70.1 to 73.7 percent in 2002 to 2012. In 2002 to 2013, 85.0 to 88.8 percent of people aged 12 or older perceived great risk from weekly LSD use. Despite these declines, more than two thirds of people aged 12 or older in 2014 perceived that trying LSD once or twice was risky, and more than four fifths perceived weekly use to be risky.

Aged 12 to 17

In 2014, the percentage of adolescents who perceived great risk from trying LSD once or twice (46.2 percent) was similar to the percentages from 2011 to 2013, but it was lower than percentages from 2002 to 2010 (Figure 5). The percentage of adolescents perceiving great risk from weekly LSD use also was lower in 2014 (68.4 percent) than in 2002 to 2013 (Table 4).

Aged 18 to 25

The percentage of young adults aged 18 to 25 who perceived great risk from trying LSD once or twice was lower in 2014 (56.4 percent) than in 2002 to 2013 (Figure 5). The percentage of young adults who perceived great risk from weekly LSD use also was lower in 2014 (77.3 percent) than in 2002 through 2012, but it was similar to the percentage in 2013 (Table 4).

Aged 26 or Older

Among adults aged 26 or older in 2014, 72.5 percent indicated there was a great risk in trying LSD once or twice (Figure 5), and 86.8 percent perceived great risk from using LSD on a weekly basis (Table 4). Although nearly three fourths of adults aged 26 or older in 2014 perceived great risk from trying LSD and more than four fifths perceived weekly LSD use to be risky, these percentages of adults in this age group who perceived great risk from LSD use were lower in 2014 than the percentages in most or all years from 2002 through 2013.

Perceived Risk from Binge Alcohol Use

In 2014, most individuals aged 12 or older perceived great risk in having four or five drinks of an alcoholic beverage nearly every day (66.1 percent) (Table 5), but less than half of people perceived great risk from having five or more drinks once or twice a week (40.3 percent) (Figure 6). For brevity, these levels of alcohol consumption are subsequently referred to as "binge alcohol use" or "binge drinking," although consumption of four drinks on an occasion is slightly less than binge alcohol use as defined in NSDUH. (Binge alcohol use is defined as having five or more drinks on the same occasion on at least 1 day in the past 30 days.18)


Figure 6. Perceived Great Risk from Having Five or More Drinks of Alcohol Once or Twice a Week among People Aged 12 or Older, by Age Group: Percentages, 2002-2014
Figure 6     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 6 Table. Perceived Great Risk from Having Five or More Drinks of Alcohol Once or Twice a Week among People Aged 12 or Older, by Age Group: Percentages, 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   42.3+   41.7+ 40.9   41.5+   41.8+   42.3+   41.3+   42.1+   43.0+   42.1+   42.4+   41.3+ 40.3
12 to 17 38.2 38.5 38.1 38.4 39.3 39.3 40.0 39.6 40.4   40.7+ 39.7 39.0 39.2
18 to 25 33.2   31.9+   31.5+ 32.7 32.6 33.2 33.0 33.2 33.7 34.5 34.5 33.2 33.5
26 or Older   44.5+   43.9+   42.9+   43.5+   43.8+   44.2+   42.9+   44.0+   44.9+   43.6+   44.1+   43.0+ 41.6

Table 5. Perceived Great Risk from Having Four or Five Drinks of Alcohol Nearly Every Day among People Aged 12 or Older, by Age Group: Percentages, 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   69.4+   68.9+   68.5+   69.0+   69.4+   69.7+   69.0+   68.4+   69.0+   68.2+   68.3+ 66.9 66.1
12 to 17 62.2 61.6 61.8   63.8+   64.5+   65.1+   65.6+   64.1+   64.7+   64.8+   63.9+ 62.5 62.4
18 to 25   62.1+ 61.1   61.7+   61.8+   62.2+   62.4+   62.9+   61.8+   62.0+   62.0+   61.4+ 59.8 60.0
26 or Older   71.7+   71.2+   70.6+   71.0+   71.4+   71.6+   70.5+   70.1+   70.7+   69.7+   70.1+   68.7+ 67.6

Perceptions of risk for binge alcohol use varied by age in 2014. Young adults aged 18 to 25 were less likely than adolescents aged 12 to 17 or adults aged 26 or older to perceive great risk from binge alcohol use nearly every day (Table 5) or on a weekly basis (Figure 6).

The percentage of individuals aged 12 or older in 2014 who perceived great risk from daily binge alcohol use was lower than in 2002 through 2012, but it was similar to the percentage in 2013 (Table 5). Nevertheless, about two thirds or more of people aged 12 or older perceived great risk from daily binge alcohol use in each year between 2002 and 2014.

The percentage of individuals aged 12 or older in 2014 who perceived great risk from binge drinking once or twice a week was also lower than the percentages in most years from 2002 to 2013 (Figure 6). Thus, despite the well-documented health problems and increased risk for serious injuries that are associated with excessive alcohol use,19 less than half of the people aged 12 or older in each year since 2002 perceived great risk from binge drinking once or twice a week.

Aged 12 to 17

The percentage of adolescents aged 12 to 17 who perceived great risk from daily binge alcohol use was lower in 2014 (62.4 percent) than in 2005 through 2012, but it was similar to the percentage in 2013 (Table 5). Nevertheless, more than three fifths of adolescents in each year between 2002 and 2014 perceived great risk from daily binge drinking. The percentage of adolescents who perceived great risk from binge drinking once or twice a week in 2014 (39.2 percent) was similar to the percentages in most years from 2002 to 2013 (Figure 6).

Aged 18 to 25

The percentage of young adults aged 18 to 25 who perceived great risk from daily binge drinking was lower in 2014 (60.0 percent) than in most years between 2002 and 2013 (Table 5). In most years between 2002 and 2014, however, at least three fifths of young adults perceived great risk from daily binge drinking.

The percentage of young adults who perceived great risk from binge alcohol use once or twice a week in 2014 (33.5 percent) was similar to the percentages in most years from 2002 to 2013 (Figure 6). In general, only about one third of young adults in most years between 2002 and 2014 perceived great risk from binge drinking once or twice a week.

Aged 26 or Older

In 2014, the percentage of adults aged 26 or older who perceived great risk from daily binge drinking (67.6 percent) was lower than in 2002 through 2013 (Table 5). The percentage of adults aged 26 or older in 2014 who perceived great risk from binge drinking once or twice a week (41.6 percent) also was lower than the percentages in 2002 through 2013 (Figure 6).

Perceived Risk from Smoking a Pack or More of Cigarettes Daily

In 2014, 71.2 percent of individuals aged 12 or older perceived great risk from smoking one or more packs of cigarettes per day (Figure 7). Perceptions of risk varied slightly by age, with adults aged 26 or older being more likely than adolescents aged 12 to 17 or young adults aged 18 to 25 to perceive great risk from smoking one or more packs of cigarettes per day. Nevertheless, about two thirds or more of people in each age group in 2014 perceived great risk from smoking a pack or more of cigarettes per day.


Figure 7. Perceived Great Risk from Smoking a Pack or More of Cigarettes a Day among People Aged 12 or Older, by Age Group: Percentages, 2002-2014
Figure 7     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 7 Table. Perceived Great Risk from Smoking a Pack or More of Cigarettes a Day among People Aged 12 or Older, by Age Group: Percentages, 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older 71.1 71.4   74.3+   74.4+   73.8+   73.8+   73.5+ 71.0 71.4 71.3 71.6 70.9 71.2
12 to 17   63.1+   64.2+   67.5+   68.3+   68.7+   68.8+   69.5+ 65.5 65.3 66.2 65.7   64.3+ 66.3
18 to 25   65.2+ 65.7   69.8+   69.8+   70.6+   70.7+   68.8+   64.8+   65.5+ 65.9 66.6 66.0 66.9
26 or Older 73.3 73.4   75.9+   76.1+   75.0+   75.0+   74.8+ 72.8 73.2 72.8 73.2 72.5 72.6

The percentage of people aged 12 or older who perceived great risk from smoking one or more packs of cigarettes per day in 2014 was lower than the percentages from 2004 to 2008, but it was similar to the percentages in 2009 to 2013. The period from 2004 to 2008 represents a span of years across all age groups in which there was a higher perception of risk from smoking than was observed in 2014.

Aged 12 to 17

The percentage of adolescents in 2014 who perceived great risk from smoking one or more packs of cigarettes a day (66.3 percent) was similar to the percentages in 2009 to 2012, but it was lower than the percentages in 2004 to 2008 (Figure 7). Despite some of these differences, the trends indicate fairly consistently between 2009 and 2014 that about two out of three adolescents perceived great risk from smoking one or more packs of cigarettes a day.

Aged 18 to 25

In 2014, about two thirds of young adults aged 18 to 25 (66.9 percent) perceived great risk from smoking one or more packs of cigarettes a day (Figure 7). This percentage in 2014 was similar to the percentages in 2011 to 2013, but it was lower than the percentages from 2004 through 2008.

Aged 26 or Older

The percentage of adults aged 26 or older in 2014 who perceived great risk from smoking one or more packs of cigarettes per day (72.6 percent) was similar to the percentages in 2009 through 2013, but it was lower than the percentages in 2004 through 2008 (Figure 7). Nevertheless, in each year between 2002 and 2014, more than 70 percent of adults aged 26 or older perceived great risk from smoking one or more packs of cigarettes a day.



Risk Perceptions and Marijuana Use, Binge Alcohol Use, and Cigarette Use


This section discusses trends in marijuana use, binge alcohol use (defined as having five or more drinks on the same occasion on at least 1 day in the past 30 days), and cigarette use because trends in substance use often have coincided with trends in perceived risk. Increases in the percentages of people perceiving great risk of harm from substance use historically have coincided with decreases in use, and decreases in the percentages of people perceiving great risk of harm have historically coincided with increases in use. However, when high percentages of the population perceive great risk of harm from using certain substances and these risk perceptions remain stable or show relatively small changes over time, as is the case with cocaine, heroin, and LSD, then changes in the percentages of the population who report current use of these substances (i.e., use in the past month) are likely to be associated with factors other than people's risk perceptions.

Therefore, the discussion in this section focuses on trends in marijuana use, binge alcohol use, and cigarette use. As shown in Table A.5B in Appendix A, these behaviors are more common in the United States than the use of cocaine, heroin, and LSD. Cigarette use and alcohol use also are legal in the United States for adults aged 18 or older (for cigarettes) or adults aged 21 or older (for alcohol). Marijuana use is illegal under federal law, but state laws regarding medical or recreational marijuana use may affect people's risk perceptions.

However, note that the cross-sectional nature of these data precludes making any causal connections between perceptions of risk and actual substance use. For example, it is not possible to determine based on these data whether respondents' perceptions of low risk of harm from substance use preceded and influenced their decision to engage in substance use or if their substance use preceded and influenced their perceptions of low risk of harm.

Risk Perceptions and Marijuana Use

Based on historical patterns, decreases in risk perceptions for marijuana use would be expected to coincide with increases in marijuana use. Consistent with these expected patterns, there was a decrease between 2002 and 2014 in the percentage of the population aged 12 or older who perceived great risk of harm from marijuana use, while there was a general increase over this same period in the percentage of the population who were current marijuana users (Figure 8).


Figure 8. Past Month Marijuana Use and Perceived Great Risk from Marijuana Use among People Aged 12 or Older: Percentages, 2002-2014
Figure 8     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 8 Table. Past Month Marijuana Use and Perceived Great Risk from Marijuana Use among People Aged 12 or Older: Percentages, 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
Past Month Marijuana Use     6.2+     6.2+     6.1+     6.0+     6.0+     5.8+     6.1+     6.7+     6.9+     7.0+     7.3+     7.5+   8.4
Perceived Great Risk
from Smoking Marijuana
Once a Month
  38.3+   39.6+   39.7+   38.3+   39.3+   38.3+   36.9+   34.4+   32.5+   31.9+   30.8+   28.2+ 26.5
Perceived Great Risk
from Smoking Marijuana
Once or Twice a Week
  51.3+   52.8+   52.4+   51.5+   51.2+   50.9+   48.7+   45.7+   43.2+   42.3+   40.3+   37.1+ 34.3

However, this pattern was not seen among youths aged 12 to 17 or young adults aged 18 to 25. Youths' perceptions of great risk from weekly or monthly marijuana use decreased between 2002 and 2014; however, the percentage of adolescents who were past month marijuana users in 2014 was similar to the percentages in most years from 2003 to 2013 (Tables A.2B and A.5B in Appendix A). For young adults aged 18 to 25, the percentage who were current marijuana users in 2014 was similar to the percentages from 2010 to 2013, although the 2014 percentage was higher than the percentages from 2002 to 2009. In contrast, the percentage of young adults who perceived great risk from marijuana use continued to decline between 2010 and 2013 (Tables A.3B and A.5B in Appendix A).

Among adults aged 26 or older, changes in the risk perceptions for marijuana use and in the use of marijuana in the past month were consistent with historical patterns, in which a change in risk perceptions is associated with a change in the opposite direction for substance use. The decrease in the percentage of adults aged 26 or older who perceived great risk from marijuana use between 2002 and 2014 coincided with a general increase in the percentage of adults in this age group who were current marijuana users (Tables A.4B and A.5B in Appendix A).

Risk Perceptions and Binge Alcohol Use

The trend for the percentage of people aged 12 or older who were binge alcohol users in the past month did not appear to be related to changes in the perceived risk for binge alcohol use. Percentages of people aged 12 or older who were binge alcohol users were stable between 2002 and 2014 (Figure 9). If people's risk perceptions for binge alcohol use and their actual drinking behaviors were closely related, then the percentages of people aged 12 or older who perceived great risk from binge alcohol use would be expected to be stable or to increase somewhat over time. However, the percentages of people aged 12 or older in 2014 who perceived great risk from weekly or daily binge alcohol use were lower than the percentages in most years from 2002 to 2013.


Figure 9. Past Month Binge Alcohol Use and Perceived Great Risk from Binge Alcohol Use among People Aged 12 or Older: Percentages, 2002-2014
Figure 9     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
Note: For brevity, reference is made in the title to the perceived risk from binge alcohol use. However, consumption of four drinks on an occasion is slightly less than binge alcohol use as defined in NSDUH.

Figure 9 Table. Past Month Binge Alcohol Use and Perceived Great Risk from Binge Alcohol Use among People Aged 12 or Older: Percentages, 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
Note: For brevity, reference is made in the title to the perceived risk from binge alcohol use. However, consumption of four drinks on an occasion is slightly less than binge alcohol use as defined in NSDUH.
Past Month Binge Alcohol Use 22.9 22.6 22.8 22.7 23.0 23.3 23.4 23.7 23.1 22.6 23.0 22.9 23.0
Perceived Great Risk from
Having Five or More Drinks
of Alcohol Once or Twice a Week
  42.3+   41.7+ 40.9   41.5+   41.8+   42.3+   41.3+   42.1+   43.0+   42.1+   42.4+   41.3+ 40.3
Perceived Great Risk from
Having Four or Five Drinks
of Alcohol Nearly Every Day
  69.4+   68.9+   68.5+   69.0+   69.4+   69.7+   69.0+   68.4+   69.0+   68.2+   68.3+ 66.9 66.1

Consistent with the increases in perceived risk from binge alcohol use among youths aged 12 to 17 between 2002 and 2008, there were decreases during this period in the percentages of youths who reported binge alcohol use (Table A.5B in Appendix A). Relationships between the perceived risk from binge alcohol use and the percentages of youths who were binge alcohol users were less consistent in recent years. In particular, the perceived risk from daily binge alcohol use among youths peaked in 2008 (Table A.2B in Appendix A). However, the estimates of binge alcohol use among adolescents continued to decline in most years between 2008 and 2014.

Among young adults aged 18 to 25, the percentage who perceived great risk from daily binge alcohol use was slightly lower in 2014 than in most years from 2002 to 2012 (Table A.3B in Appendix A). This suggests that the percentage of young adults who were binge alcohol users would increase during this period. However, the percentage of young adults who engaged in binge drinking in 2014 was lower than the percentages in each year from 2002 to 2012 (Table A.5B in Appendix A).

As noted previously, adults aged 26 or older were less likely in 2014 to perceive great risk from daily or weekly binge drinking than in 2002 to 2013 (Table A.4B in Appendix A). Despite the decreases in perceptions of risk from daily binge drinking among adults aged 26 or older, the percentage who were binge drinkers in 2014 was similar to the percentages in most years from 2007 to 2013 (Table A.5B in Appendix A).

Risk Perceptions and Cigarette Smoking

Compared with percentages in 2002 and 2003, the percentage of people aged 12 or older who perceived great risk from smoking a pack or more of cigarettes a day increased somewhat from 2004 to 2008. Consistent with this increase, the percentage of people aged 12 or older who were current cigarette smokers in 2008 also was lower than in 2002 to 2006 (Figure 10). Between 2009 and 2014, however, the percentage of people aged 12 or older who perceived great risk from smoking a pack or more of cigarettes per day stabilized. The percentage of people aged 12 or older who were current cigarette smokers also would be expected to stabilize. Instead, the percentage of people who were current cigarette smokers continued to decline.


Figure 10. Past Month Cigarette Use and Perceived Great Risk from Cigarette Use among People Aged 12 or Older: Percentages, 2002-2014
Figure 10     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 10 Table. Past Month Cigarette Use and Perceived Great Risk from Cigarette Use among People Aged 12 or Older: Percentages, 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
Past Month Cigarette Use   26.0+   25.4+   24.9+   24.9+   25.0+   24.3+   24.0+   23.3+   23.0+   22.1+   22.1+ 21.3 20.8
Perceived Great Risk from
Smoking One or More Packs
of Cigarettes per Day
71.1 71.4   74.3+   74.4+   73.8+   73.8+   73.5+ 71.0 71.4 71.3 71.6 70.9 71.2

Similarly, the percentage of people who smoked cigarettes might be expected to increase as perceptions of risk of harm from cigarette use decrease. However, this pattern was not found for adolescents. As noted previously, the percentage of youths in 2014 who perceived great risk from smoking a pack or more of cigarettes per day was lower than the percentages in 2004 to 2008, and it was similar to the percentages in 2009 to 2013 (Table A.2B in Appendix A). In contrast, the percentage of youths in 2014 who were past month cigarette smokers (4.9 percent) was lower than in any year from 2002 to 2013 (Table A.5B in Appendix A).

For young adults aged 18 to 25, similar percentages in 2011 to 2014 perceived great risk of harm from smoking a pack or more of cigarettes per day (Table A.3B in Appendix A). However, the percentage of young adults who smoked cigarettes in the past month continued to decline from 2011 to 2014 (Table A.5B in Appendix A).

In recent years, the percentages have stabilized for adults aged 26 or older who perceived great risk of harm from smoking a pack or more of cigarettes per day and for past month cigarette use in this age group. As noted previously, similar percentages of adults aged 26 or older in 2009 to 2014 perceived great risk of harm from smoking a pack or more of cigarettes per day (Table A.4B in Appendix A). The percentage of adults in this age group in 2014 who smoked cigarettes in the past month (21.5 percent) also was similar to the percentages in 2011 to 2013 (Table A.5B in Appendix A).



Trends in Perceived Availability of Specific Drugs


Many studies have demonstrated that the availability of drugs (i.e., ease of obtaining drugs) is associated with drug initiation and use.2,3,20 Perceptions of drug availability are also important because they may affect how prevention programs are structured, especially in states with laws related to medical or recreational marijuana use that can directly affect availability.21

NSDUH respondents were asked how easy it would be for them to obtain substances, if they wanted some; they were given the response options of "very easy," "fairly easy," "fairly difficult," "very difficult," or "probably impossible." This section provides estimates for people in different age groups who thought it would be "fairly easy" or "very easy" to obtain the substance. However, respondents could report that they did not know how easy or difficult it would be to obtain a substance, or they could refuse to answer the question; these respondents were excluded from the analysis.22

Aged 12 to 17

In 2014, about half (47.8 percent) of youths aged 12 to 17 reported that it would be fairly easy or very easy for them to obtain marijuana if they wanted some (Figure 11). Slightly less than 1 in 10 (9.4 percent) indicated that heroin would be easily obtainable, about 1 in 9 (11.6 percent) reported that it would be easy to obtain LSD, and about 1 in 7 (14.4 percent) reported that it would be easy to obtain cocaine. The percentages of adolescents in 2014 who indicated that it would be easy to get cocaine and crack were lower than the corresponding percentages in each year from 2002 through 2012 (Table A.2B in Appendix A). For LSD and heroin, the percentages of youths in 2014 who reported that it would be easy to obtain these substances were lower than the corresponding percentages in most years from 2002 through 2011. However, the percentages of adolescents who reported that it would be easy to obtain all five of these substances were similar between 2013 and 2014. The percentage of youths who perceived that marijuana would be fairly easy or very easy to obtain was lower in 2014 than in 2002 through 2009, but it was similar to the percentages in 2010 to 2013.


Figure 11. Perceived Availability of Substances among Youths Aged 12 to 17: Percentages, 2002-2014
Figure 11     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 11 Table. Perceived Availability of Substances among Youths Aged 12 to 17: Percentages, 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
Note: Percent indicating substance was fairly or very easy to obtain.
Marijuana   55.0+   53.6+   52.2+   51.0+   50.1+   49.2+   49.4+   50.0+ 48.9 47.7 47.8 48.6 47.8
Cocaine   25.0+   25.0+   24.4+   24.9+   25.9+   24.5+   22.1+   20.9+   19.1+   17.5+   16.0+ 14.4 14.4
Heroin   15.8+   15.3+   14.0+   14.0+   14.4+   14.2+   12.9+   12.8+   11.6+   10.7+   9.9   9.1   9.4
LSD   19.4+   17.6+   16.9+   15.7+   14.0+   14.4+   13.7+   13.4+   13.0+ 12.2 11.5 11.3 11.6

Aged 18 to 25

About 3 out of 4 young adults aged 18 to 25 in 2014 reported that it would be easy for them to get marijuana if they wanted some (Table A.3B in Appendix A). The percentage who reported that it would be easy for them to get marijuana in 2014 (74.9 percent) was similar to the percentages in most years from 2007 to 2013, but it was lower than the percentages in most years from 2002 through 2006. About a quarter of young adults reported that they could easily get cocaine (27.5 percent), and about 1 in 5 (19.0 percent) reported that they could easily get crack; these percentages for young adults in 2014 were lower than those in 2002 through 2012, but they were unchanged from 2013. In 2014, about 1 in 7 young adults (15.0 percent) reported that it would be easy for them to get heroin. This percentage was similar to those in 2011 to 2013, but it was lower than in 2002 through 2010. In 2014, about 1 in 6 young adults (17.1 percent) believed it would be easy for them to get LSD if they wanted some. The percentage of young adults in 2014 who reported that it would be easy to get LSD was similar to the percentages in 2011 to 2013, but it was lower than in 2002 through 2010.

Aged 26 or Older

In 2014, more than half of adults aged 26 or older (59.2 percent) believed it would be easy for them to get marijuana if they wanted some (Table A.4B in Appendix A). The percentage of adults in this age group who reported in 2014 that it would be easy to get marijuana was higher than the percentages from 2002 to 2013. About a quarter of adults aged 26 or older believed it would be easy for them to get cocaine (25.2 percent) or crack (23.1 percent); these percentages for 2014 were lower than those in 2002 through 2011, but they were similar to those in 2012 and 2013. In 2014, about 1 in 6 adults aged 26 or older (18.0 percent) reported that it would be easy for them to get heroin. The percentage of adults aged 26 or older who believed it would be easy to get heroin in 2014 was similar to the percentages from 2002 to 2008, but it was higher than the percentages from 2009 through 2013. About 1 in 7 adults aged 26 or older in 2014 (13.8 percent) reported that it would be easy for them to get LSD if they wanted some. This percentage was similar to those in 2012 and 2013, but it was lower than the percentages in 2002 through 2011.



Being Approached by Someone Selling Drugs


Another way to assess the risk of drug initiation or use in a person's community is to determine if people selling drugs are actively soliciting users. NSDUH respondents were asked if they had been approached by someone selling drugs in the past month. Results are presented by age group.

Aged 12 to 17

In 2014, about 1 in 8 youths aged 12 to 17 (12.1 percent) indicated that they had been approached by someone selling drugs in the past month (Table A.2B in Appendix A). This percentage was similar to the percentage in 2013, but it was lower than percentages in 2002 to 2012.

Aged 18 to 25

About 1 in 6 young adults aged 18 to 25 in 2014 (16.2 percent) reported that they had been approached by someone in the past month who was selling drugs (Table A.3B in Appendix A). This percentage in 2014 was lower than percentages in 2002 through 2012, but it was unchanged from 2013.

Aged 26 or Older

In 2014, 4.2 percent of adults aged 26 or older reported that they had been approached in the past month by someone selling drugs (Table A.4B in Appendix A). The percentage of adults in this age group in 2014 who were approached in the past month by someone selling drugs was similar to the percentages in most years from 2002 through 2013.



Youth Perceptions of Parental Disapproval of Youth Substance Use


Parental disapproval of their adolescent children engaging in substance use and adolescents' perceptions of the level of parental disapproval of youth substance use have been linked to initiation of substance use and substance use in general among adolescents.2 NSDUH respondents aged 12 to 17 are asked whether their parents would "neither approve nor disapprove," "somewhat disapprove," or "strongly disapprove" if they used different substances. This section presents percentages of youths who believed that their parents would "strongly disapprove" of them using specific substances.

In 2014, 87.5 percent of youths reported that their parents would strongly disapprove of them trying marijuana or hashish once or twice (Table A.6B in Appendix A). This percentage in 2014 was slightly lower than the percentages in 2002 to 2013, which ranged from 88.4 to 91.0 percent.

Most youths in 2014 (90.6 percent) reported that their parents would strongly disapprove of them having one or two drinks of an alcoholic beverage nearly every day. This percentage in 2014 was similar to the percentages in 2009 to 2013, but it was somewhat higher than the percentages in 2002 to 2008, which ranged from 88.5 to 89.7 percent.

In 2014, most youths (93.8 percent) reported that their parents would strongly disapprove of them smoking one or more packs of cigarettes per day. This percentage was similar to the percentages in 2011 to 2013, but it was higher than the percentages in 2002 to 2010, which ranged from 89.5 to 92.6 percent.



Youth Disapproval of Peers' Substance Use


Research has also linked adolescents' attitudes about their peers' substance use with substance initiation and use.2 NSDUH respondents aged 12 to 17 are asked whether they would "neither approve nor disapprove," "somewhat disapprove," or "strongly disapprove" if someone their age used different substances. This section presents percentages for youths who either "somewhat disapproved" or "strongly disapproved" of specific substance use by their peers. About 4 out of 5 youths in 2014 (79.2 percent) strongly or somewhat disapproved of peers using marijuana or hashish once a month or more (Table A.7B in Appendix A). This percentage was lower than the percentages in 2002 to 2012, but it was unchanged from 2013. In 2007, for example, 82.9 percent of youths strongly or somewhat disapproved of their peers using marijuana once a month or more. In 2014, 89.7 percent of youths strongly or somewhat disapproved of peers having one or two drinks of an alcoholic beverage nearly every day (Table A.7B in Appendix A). This percentage was higher than the percentages in 2002 to 2013. Nevertheless, about 85 percent or more of adolescents in most of the years between 2002 and 2014 strongly or somewhat disapproved of their peers having one or two drinks of an alcoholic beverage nearly every day.

In 2014, 92.5 percent of youths strongly or somewhat disapproved of their peers smoking one or more packs of cigarettes per day (Table A.7B in Appendix A). This percentage in 2014 was higher than the percentages in 2002 to 2013, which ranged from 87.1 to 91.4 percent.



Youth Exposure to Substance Use Prevention Messages


Preventing substance use and substance use disorders are fundamental to SAMHSA's mission to reduce the impact of behavioral health conditions in America's communities. Youths aged 12 to 17 in NSDUH are asked a series of questions about their exposure to substance use prevention messages from different sources.

Prevention Messages from Posters or Pamphlets, on the Radio, or on Television

In 2014, 72.9 percent of youths aged 12 to 17 reported having seen or heard drug or alcohol prevention messages in the past year from sources outside of school, such as posters, pamphlets, the radio, or television (Figure 12). The percentage in 2014 was lower than the percentages in 2002 to 2012, but it was similar to the percentage in 2013.


Figure 12. Exposure to Substance Use Prevention Messages and Programs among Youths Aged 12 to 17: Percentages, 2002-2014
Figure 12     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 12 Table. Exposure to Substance Use Prevention Messages and Programs among Youths Aged 12 to 17: Percentages, 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
Outside of School   83.2+   83.6+   83.0+   81.1+   79.3+   77.8+   77.9+   76.9+   75.9+   75.1+   75.9+ 72.6 72.9
At School   78.8+   78.1+   78.2+   77.9+   76.9+   75.8+   76.1+   75.2+   75.7+   74.6+   75.0+ 73.5 73.0

Among youths in 2014 who were exposed to prevention messages from posters, pamphlets, the radio, or television in the past year, 9.1 percent were current (i.e., past month) users of illicit drugs, 7.1 percent were current marijuana users, 4.5 percent were current cigarette users, and 5.9 percent were binge alcohol users in the past month (Table A.9B in Appendix A). Among youths in 2014 who did not report exposure to prevention messages from these sources, 9.9 percent were current illicit drug users, 7.8 percent were current marijuana users, 5.7 percent were current cigarette users, and 6.4 percent were binge alcohol users in the past month. Compared with youths who were not exposed to messages from these sources, however, the only estimate that was lower among youths who were exposed to these messages was for current cigarette use. Nevertheless, the long-term trends from 2002 to 2014 show that youths who were exposed to prevention messages outside of school were generally less likely to be substance users than were youths who did not report such exposure.

Prevention Messages at School

In 2014, 73.0 percent of youths aged 12 to 17 who were enrolled in school in the past year reported having seen or heard drug or alcohol prevention messages at school (Figure 12). This percentage was lower than the percentages in 2002 to 2012, but it was unchanged from the percentage in 2013. In 2002, for example, 78.8 percent of adolescents who were enrolled in school reported exposure to substance use prevention messages at school.

In 2014, youths in school who reported having exposure to prevention messages at school were less likely than their counterparts without such exposure to report past month use of illicit drugs (8.5 vs. 12.3 percent), marijuana (6.6 vs. 9.9 percent), and cigarettes (3.9 vs. 7.4 percent) (Table A.9B in Appendix A). Youths in school who were exposed to prevention messages at school were less likely to be binge alcohol users (5.4 percent) compared with youths in school who were not exposed to these messages (7.9 percent). This pattern of lower estimates of illicit drug use, marijuana use, cigarette use, and binge alcohol use for youths who reported exposure to prevention messages at school was generally consistent from 2002 to 2014.

Prevention Programs Outside of School

In 2014, 1 in 9 youths aged 12 to 17 (11.1 percent) reported that they had participated in alcohol, tobacco, or drug prevention programs outside of school in the past year (Table A.8B in Appendix A). This estimate was similar to the percentages in most years from 2005 to 2013, but it was lower than the percentages in 2002 to 2004. In 2003, for example, 13.9 percent of youths reported that they had participated in prevention programs outside of school in the past year.

In 2014, estimates of substance use in the past month were similar for youths who did or did not participate in these programs (Table A.9B in Appendix A). Among youths who participated in these prevention programs, 9.4 percent were current users of illicit drugs, 7.0 percent were current marijuana users, 4.8 percent were current cigarette users, and 5.4 percent were binge alcohol users in the past month. Corresponding percentages among youths who did not participate in these programs were 9.3 percent for current illicit drug use, 7.3 percent for current marijuana use, 4.8 percent for current cigarette use, and 6.1 percent for past month binge alcohol use.

The long-term trends in the relationship between exposure to prevention messages through participation in programs outside of school and past month substance use indicate that substance use among youths who are exposed to prevention messages is either similar to or lower than substance use among youths who are not exposed to prevention messages outside of school. This finding may reflect some youths participating in substance use prevention programs outside of school because they are already using substances.



Initiation of Substance Use


If NSDUH respondents reported that they ever used a particular substance, they are asked to report their age when they first used it (i.e., initiation). Respondents who reported first use of a substance relatively recently (i.e., within a year of their current age) also are asked to report the year and month when they first used it. The estimates of the number of substance use initiates in this report are limited to recent initiates of substance use.23 Recent initiates are defined as substance users who reported that they first used a particular substance within 12 months of the date of their interview. More information about methods for measuring and estimating the initiation of substance use in NSDUH can be found on the web in Section B.4.1 of the 2014 NSDUH's methodological summary and definitions report (see the reference in endnote 9).

Unlike previous sections, this section focuses on trends in the number of people who were recent initiates for a substance (e.g., the number of people aged 12 or older who were recent initiates of marijuana use) rather than on percentages. Information on changes in the number of recent initiates over time can be useful to policymakers and program planners for anticipating future needs for medical and behavioral health services both in the short term and in the longer term. For example, decreases in the number of people who have initiated use of cigarettes might translate over time into fewer new cases of people with chronic bronchitis, emphysema, heart disease, or lung cancer. In contrast, increases in the number of people who have initiated use of substances such as heroin could signal future needs for emergency medical services, treatment for infectious diseases such as hepatitis, or substance use treatment. However, care should be taken in interpreting increases over time in the estimated number of initiates because some of these increases could reflect growth in the size of the population.

This section also presents trends in the average age at first use among recent initiates for use of a substance. NSDUH respondents who started using a substance relatively recently would be expected to have less difficulty remembering how old they were when they first used it compared with respondents whose first use occurred several years prior to the interview. Although trends in the numbers of initiates are shown for initiates aged 12 or older as well as by age group, trends in the average age at first use in this report are limited to all past year initiates aged 12 to 49 to avoid having the averages be influenced by extreme values. For example, a small number of people who started using a substance at very late ages could artificially inflate the average age at first use among all initiates.

Figure 13 provides an overview of the numbers of past year initiates in 2014 for the majority of substances that are discussed in this section of the report. The illicit drugs with the largest number of recent initiates in 2014 were marijuana (2.6 million new users), pain relievers (1.4 million new users), and tranquilizers (1.1 million new users). In addition, there were 4.7 million new users of alcohol, 2.2 million people who tried a cigarette for the first time in the past year, and 1.0 million people who first used smokeless tobacco in the past year.24


Figure 13. Numbers of Past Year Initiates of Selected Substances among People Aged 12 or Older: 2014
Figure13      D

Initiation of Marijuana Use

In 2014, about 2.6 million people aged 12 or older used marijuana for the first time within the past 12 months (Figure 13). This averages to about 7,000 new marijuana users each day. The 2014 estimate was similar to the estimates in 2009 through 2013, but it was higher than the estimates from 2002 through 2008, when about 2.0 million to 2.2 million people per year were recent initiates of marijuana use (Figure 14).


Figure 14. Past Year Marijuana Initiates among People Aged 12 or Older, by Age Group (in millions): 2002-2014
Figure 14     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 14 Table. Past Year Marijuana Initiates among People Aged 12 or Older, by Age Group (in millions), and Mean Age at First Use of Marijuana among Past Year Marijuana Initiates Aged 12 to 49: 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   2.2+   2.0+   2.1+   2.1+   2.1+   2.1+   2.2+ 2.4 2.4 2.6 2.4 2.4 2.6
12 to 17   1.4+ 1.2 1.3 1.1 1.2 1.2 1.2   1.3+ 1.3   1.4+ 1.3 1.2 1.2
18 to 25   0.7+   0.7+   0.7+   0.7+   0.7+   0.8+   0.8+ 1.0   0.9+ 1.1 1.0 1.0 1.1
26 or Older   0.1+   0.1+ 0.2 0.3   0.1+   0.1+ 0.2   0.0+ 0.2 0.2 0.2 0.2 0.3
Mean Age at First Use 17.0+ 16.8+ 17.1+ 17.4+ 17.4+ 17.6+ 17.8 17.0+ 18.4 17.5+ 17.9 18.0 18.5

In 2014, the average age at first marijuana use among recent marijuana initiates aged 12 to 49 was 18.5 years, which was higher than the average ages in 2002 through 2007, 2009, and 2011, but it was similar to the average ages in the remaining years that were compared with 2014. Although new marijuana users aged 12 to 49 initiated use on average in their late teens, these trend data suggest that new users on average were initiating use at a somewhat later age in 2014 compared with initiation in some earlier years.

By Age Group

In 2014, an estimated 1.2 million adolescents aged 12 to 17 used marijuana for the first time in the past year (Figure 14), which translates to approximately 3,300 adolescents initiating marijuana use each day. About 1.1 million to 1.4 million adolescents per year in 2002 to 2013 were recent marijuana initiates. The 2014 estimate was similar to the estimates in most of the years from 2002 to 2013, although the 2014 estimate was lower than the corresponding estimates in 2002, 2009, and 2011.

There were 1.1 million young adults aged 18 to 25 in 2014 who initiated marijuana use in the past year, or an average of about 3,000 recent initiates per day in this age group (Figure 14). The 2014 estimate for young adults was similar to the numbers in most years since 2009, but it was higher than the numbers in 2002 to 2008.

An estimated 271,000 adults aged 26 or older in 2014 also initiated marijuana use in the past year (Figure 14). The number of recent marijuana initiates per year in this age group was stable between 2010 and 2014, but it was higher than the numbers of initiates in most years from 2002 to 2009.

Initiation of Nonmedical Pain Reliever Use

In 2014, the number of recent initiates for nonmedical use of pain relievers (1.4 million) was second only to the number of marijuana initiates (Figure 13).25 The number of people aged 12 or older who used pain relievers nonmedically for the first time within the past year averages to about 3,900 initiates per day. The number of new nonmedical users of pain relievers in 2014 was lower than the numbers in 2002 through 2012 (ranging from 1.9 million to 2.5 million initiates each year), but it was similar to the number of initiates in 2013 (Figure 15).


Figure 15. Past Year Pain Reliever Initiates among People Aged 12 or Older, by Age Group (in millions): 2002-2014
Figure 15     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 15 Table. Past Year Pain Reliever Initiates among People Aged 12 or Older, by Age Group (in millions), and Mean Age at First Use of Pain Relievers among Past Year Pain Reliever Initiates Aged 12 to 49: 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   2.3+   2.5+   2.4+   2.2+   2.2+   2.2+   2.2+   2.2+   2.0+   1.9+   1.9+ 1.5 1.4
12 to 17   0.9+   0.9+   0.9+   0.8+   0.8+   0.8+   0.8+   0.8+   0.7+   0.7+   0.6+ 0.5 0.5
18 to 25   0.9+   0.9+   0.8+   0.8+   0.8+   0.9+   0.8+   0.8+   0.7+   0.7+   0.7+ 0.6 0.6
26 or Older 0.5   0.6+   0.7+   0.6+   0.6+ 0.6 0.5   0.6+ 0.5 0.5   0.6+ 0.4 0.4
Mean Age at First Use 20.8 21.1 20.9 21.2 22.0 21.2 21.2 20.8 21.0 21.8 22.3 21.7 21.2

In 2014, the average age at first nonmedical use of pain relievers among recent pain reliever initiates aged 12 to 49 was 21.2 years. The average age at first use of pain relievers in 2014 was similar to the average ages from 2002 to 2013.

By Age Group

In 2014, an estimated 489,000 adolescents aged 12 to 17 used pain relievers nonmedically for the first time in the past year (Figure 15). This averages to approximately 1,300 adolescents each day who initiated nonmedical use of pain relievers. The number of adolescents in 2014 who initiated nonmedical use of pain relievers in the past year was lower than the numbers in 2002 to 2012, but it was similar to the number in 2013.

There were 574,000 young adults aged 18 to 25 and 362,000 adults aged 26 or older in 2014 who initiated nonmedical use of pain relievers in the past year (Figure 15). These numbers average to about 1,600 young adults and about 1,000 adults aged 26 or older who initiated nonmedical use of pain relievers each day. For young adults, the number of recent initiates for nonmedical use of pain relievers in 2014 was lower than the numbers in 2002 to 2012, but it was similar to the number in 2013. For adults aged 26 or older, the number of recent initiates for nonmedical use of pain relievers in 2014 was lower than the numbers in 2003 to 2006, 2009, and 2012, but it was similar to the numbers in the remaining years.

Initiation of Nonmedical Tranquilizer Use

About 1.1 million people aged 12 or older in 2014 used tranquilizers nonmedically for the first time within the past year (Figure 13). This averages to about 3,100 initiates per day.25 There was little change in the number of past year initiates for nonmedical use of tranquilizers in most years between 2002 and 2014 (Table A.10A in Appendix A). These trend data indicate that between 2002 and 2014, at least 1 million people each year recently initiated nonmedical use of tranquilizers.

In 2014, the average age at first nonmedical use of tranquilizers among recent tranquilizer initiates aged 12 to 49 was 23.4 years (Table A.14B in Appendix A). This average age in 2014 was similar to the average ages in most years between 2002 and 2013.

By Age Group

In 2014, an estimated 254,000 adolescents aged 12 to 17, 440,000 young adults aged 18 to 25, and 439,000 adults aged 26 or older used tranquilizers nonmedically for the first time in the past year (Tables A.11A, A.12A, and A.13A in Appendix A). Thus, about 700 adolescents, 1,200 young adults, and 1,200 adults aged 26 or older initiated nonmedical use of tranquilizers per day in 2014. The numbers of adolescents, young adults, and adults aged 26 or older who were recent initiates for nonmedical use of tranquilizers were similar between 2002 and 2014.

Initiation of Nonmedical Stimulant Use and Methamphetamine Use

In 2014, approximately 690,000 people aged 12 or older used stimulants nonmedically,25 and 183,000 used methamphetamine for the first time within the past year (Figure 13).26 These estimated numbers of initiates in 2014 average to about 1,900 initiates per day for nonmedical use of stimulants and to about 500 initiates per day for methamphetamine use.

The number of recent initiates aged 12 or older for nonmedical use of stimulants was stable between 2002 and 2014 (Figure 16). For methamphetamine, the number of recent new users among the population aged 12 or older in 2014 was higher than the numbers in 2008 and 2010 and was lower than the numbers in 2002 and 2004 (Figure 17). The number of methamphetamine initiates in 2014 was similar to the estimates in the remaining years. In 2004, for example, there were an estimated 318,000 recent methamphetamine initiates aged 12 or older, or about 870 initiates per day.


Figure 16. Past Year Stimulant Initiates among People Aged 12 or Older, by Age Group (in thousands): 2002-2014
Figure 16     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 16 Table. Past Year Stimulant Initiates among People Aged 12 or Older, by Age Group (in thousands), and Mean Age at First Use of Stimulants among Past Year Stimulant Initiates Aged 12 to 49: 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older 783 715 793 647 846 640 602 710 626 670 676 603 690
12 to 17   341+   292+   271+   264+   296+ 224 196 196 190 169 183 138 183
18 to 25 337   240+ 344 276 310 276 282 351 327 315 332 345 356
26 or Older 106 183 178 108 239 140 124 163 108 185 160 121 152
Mean Age at First Use 19.2+ 21.5 20.0 20.1 23.0 21.9 21.3 21.5 21.2 22.2 22.1 21.6 21.6

Figure 17. Past Year Methamphetamine Initiates among People Aged 12 or Older, by Age Group (in thousands): 2002-2014
Figure 17     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 17 Table. Past Year Methamphetamine Initiates among People Aged 12 or Older, by Age Group (in thousands), and Mean Age at First Use of Methamphetamine among Past Year Methamphetamine Initiates Aged 12 to 49: 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   299+ 260   318+ 192 259 157   97+ 155   107+ 133 133 144 183
12 to 17   131+   107+     99+   84   85   70 45   49   45   76   31   40   51
18 to 25   132+   92   139+   88 100   71 37   86   52   41   85   93   67
26 or Older   36   61   80   21   74   16+ 15+   20   10+   17+   16   11+   65
Mean Age at First Use 18.9+ 20.4 20.6 18.6+ 22.2 19.4 19.3 19.3 18.8+ 17.8+ 19.7 18.9+ 22.0

In 2014, the average age at first use of stimulants among recent initiates aged 12 to 49 was 21.6 years and was similar to estimates between 2003 and 2013. The average age at first methamphetamine use in 2014 among recent methamphetamine initiates aged 12 to 49 was 22.0 years, which was higher than the averages in 2002, 2005, 2010, 2011, and 2013, but it was similar to the averages in other years that were compared.

By Age Group

In 2014, an estimated 183,000 adolescents aged 12 to 17, 356,000 young adults aged 18 to 25, and 152,000 adults aged 26 or older used stimulants nonmedically for the first time in the past year (Figure 16). For methamphetamine, 51,000 adolescents, 67,000 young adults, and 65,000 adults aged 26 or older were recent initiates in 2014 (Figure 17).

The number of adolescents in 2014 who were recent initiates of nonmedical use of stimulants was similar to the numbers in 2007 to 2013, but it was lower than the numbers for prior years (Figure 16). For young adults, the number of recent initiates of nonmedical use of stimulants in 2014 was similar to the numbers in all years since 2002 except for 2003. For adults aged 26 or older, the numbers of recent stimulant initiates were similar between 2002 and 2014.

For the initiation of methamphetamine use, the number of adolescents in 2014 who were recent initiates was lower than the numbers in 2002 to 2004, but it was similar to the numbers in the remaining years that were compared (Figure 17). For young adults, the number of recent methamphetamine initiates in 2014 was lower than the numbers in 2002 and 2004, but it was similar to the numbers in 2005 to 2013. For adults aged 26 or older, the number of recent methamphetamine initiates in 2014 was similar to the numbers in 2002 to 2006, but it was higher than the numbers in most years between 2007 and 2013.

Initiation of Nonmedical Sedative Use

In 2014, approximately 173,000 people aged 12 or older used sedatives nonmedically for the first time within the past year (Figure 13).25 The number of recent initiates for the nonmedical use of sedatives in 2014 was similar to the numbers in 2002 to 2013 (Figure 18).


Figure 18. Past Year Sedative Initiates among People Aged 12 or Older, by Age Group (in thousands): 2002-2014
Figure 18     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 18 Table. Past Year Sedative Initiates among People Aged 12 or Older, by Age Group (in thousands), and Mean Age at First Use of Sedatives among Past Year Sedative Initiates Aged 12 to 49: 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older 209 194 240 247 267 198 183 186 253 159 166 128 173
12 to 17   63   66   66   59   63   67   69   76   65   54   44     26+   59
18 to 25   53   42   53   67   60   51   57   63   80   49   41   35   64
26 or Older   93   86 121 121   145+   80   56   48 108   56   82   68   50
Mean Age at First Use 26.6 21.2 23.5 22.9 26.5+ 24.3 21.6 19.7 23.5 22.0 26.2+ 25.0 21.4

In 2014, the average age at first nonmedical use of sedatives among recent initiates aged 12 to 49 was 21.4 years. This average age was similar to the average ages in most years between 2002 and 2013.

By Age Group

In 2014, an estimated 59,000 adolescents aged 12 to 17, 64,000 young adults aged 18 to 25, and 50,000 adults aged 26 or older used sedatives nonmedically for the first time in the past year (Figure 18). The number of adolescents who were recent initiates for nonmedical use of sedatives in 2014 was similar to the numbers in 2002 to 2012, but it was higher than the number in 2013. Similar numbers of young adults aged 18 to 25 in 2002 to 2014 were recent initiates for the nonmedical use of sedatives. The number of adults aged 26 or older in 2014 who were recent initiates was similar to the numbers in most years from 2002 to 2013; the higher estimate in 2006 for adults aged 26 or older may represent a statistical anomaly.

Initiation of Cocaine Use

In 2014, there were 766,000 people aged 12 or older who used cocaine for the first time in the past year (Figure 13). This averages to approximately 2,100 cocaine initiates per day. The 2014 estimate was higher than the estimate in 2013, but it was similar to the estimates in 2007 to 2012 (Figure 19).27 The 2014 estimate also was lower than the estimates in most years from 2002 through 2006. Data from future years would be useful for evaluating whether the difference between 2013 and 2014 represents a real change or a statistical anomaly.


Figure 19. Past Year Cocaine Initiates among People Aged 12 or Older, by Age Group (in millions): 2002-2014
Figure 19     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 19 Table. Past Year Cocaine Initiates among People Aged 12 or Older, by Age Group (in millions), and Mean Age at First Use of Cocaine among Past Year Cocaine Initiates Aged 12 to 49: 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   1.0+   1.0+   1.0+ 0.9   1.0+ 0.9 0.7 0.6 0.6 0.7 0.6   0.6+ 0.8
12 to 17   0.3+   0.3+   0.3+   0.3+   0.3+   0.3+   0.2+ 0.1 0.2 0.1 0.1 0.1 0.1
18 to 25 0.6 0.6 0.6 0.5 0.6 0.5 0.4   0.4+   0.4+ 0.5 0.4 0.4 0.5
26 or Older 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1   0.1+ 0.1 0.1 0.1
Mean Age at First Use 19.8+ 19.8+ 20.0+ 19.7+ 20.3+ 20.2+ 19.8+ 19.9+ 21.2 20.1+ 20.0+ 20.4+ 21.8

In 2014, the average age at first cocaine use among recent cocaine initiates aged 12 to 49 was 21.8 years. This average increased somewhat from the very late teens in most years from 2002 to 2009 to the early 20s in 2014.

By Age Group

In 2014, an estimated 117,000 adolescents aged 12 to 17 used cocaine for the first time in the past year (Figure 19). Also in 2014, 501,000 young adults aged 18 to 25 and 148,000 adults aged 26 or older initiated cocaine use in the past year. Among adolescents, the number of cocaine initiates in 2014 was lower than those in 2002 to 2008, but it was similar to the numbers in 2009 to 2013. Among young adults and adults aged 26 or older, the number of cocaine initiates in 2014 was similar to the numbers in most prior years.

Initiation of Crack Cocaine Use

There were 109,000 recent crack cocaine initiates aged 12 or older in 2014 (Figure 20). The number of recent initiates in 2014 was lower than the numbers in 2002 through 2008, when 209,000 to 353,000 individuals per year were recent crack initiates. Between 2009 and 2014, the numbers of initiates were similar, ranging between 58,000 to 109,000 recent initiates per year.


Figure 20. Past Year Crack Cocaine Initiates among People Aged 12 or Older, by Age Group (in thousands): 2002-2014
Figure 20     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 20 Table. Past Year Crack Cocaine Initiates among People Aged 12 or Older, by Age Group (in thousands), and Mean Age at First Use of Crack Cocaine among Past Year Crack Cocaine Initiates Aged 12 to 49: 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   337+   269+   215+   230+   243+   353+   209+ 95 83 76 84 58 109
12 to 17     86+     76+     42+     32+     41+     52+   17 18 14 19 18 10   11
18 to 25   100+   109+   120+   142+   132+   88   91 62 39 40 49 25   54
26 or Older   151+   83   53   55   70   212+ 101 15 30 17 17 23   44
Mean Age at First Use 25.0 21.8 21.9 23.4 22.8 29.6 27.1 20.6+ 24.8 20.8 20.5 24.4 26.4

In 2014, the average age at first crack use among recent crack initiates aged 12 to 49 was 26.4 years. This average age in 2014 was similar to the average ages at first use in most years between 2002 and 2013.

By Age Group

In 2014, an estimated 11,000 adolescents aged 12 to 17, 54,000 young adults aged 18 to 25, and 44,000 adults aged 26 or older used crack for the first time in the past year (Figure 20). The number of recent adolescent crack initiates in 2014 was similar to the number of initiates in 2008 to 2013, but it was lower than the numbers in 2002 to 2007. The number of young adult crack initiates in 2014 was lower than the numbers in 2002 to 2006, but it was similar to the numbers in 2007 to 2013. For adults aged 26 or older, there have been few significant differences in the numbers of recent crack initiates since 2003. However, caution is advised in interpreting some of the larger year-to-year fluctuations in the numbers of crack initiates aged 26 or older prior to 2009. These fluctuations are likely to reflect the kinds of single-year anomalies that were mentioned in the data presentation and interpretation section of this report.

Initiation of Heroin Use

In 2014, there were 212,000 people aged 12 or older who used heroin for the first time within the past year (Figure 13). On average, this represents roughly 600 people initiating heroin use each day. The number of past year heroin initiates in 2014 was similar to the numbers of recent heroin initiates in 2009 to 2013, but it was higher than the numbers in 2002 to 2008 (Figure 21).


Figure 21. Past Year Heroin Initiates among People Aged 12 or Older, by Age Group (in thousands): 2002-2014
Figure 21     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 21 Table. Past Year Heroin Initiates among People Aged 12 or Older, by Age Group (in thousands), and Mean Age at First Use of Heroin among Past Year Heroin Initiates Aged 12 to 49: 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   117+   92+   118+   108+   90+   106+   116+ 187 142 178 156 169 212
12 to 17     39+ 25   31   18 24   16   29   19   23     38+   21   21   13
18 to 25   66 42   46   57 56   70   58   83   83 100   95   66   75
26 or Older     12+   25+     40+     33+     9+     20+     28+   85     37+     40+     40+   82 124
Mean Age at First Use 21.0+ 20.9+ 24.4 22.2+ 20.7+ 21.8+ 23.5 25.3 21.4+ 22.1+ 23.0+ 24.5 28.0

In 2014, the average age at first heroin use among recent heroin initiates aged 12 to 49 was 28.0 years. This average age was higher than the average ages in most years between 2002 and 2013. Data from future years would be useful for evaluating whether the higher average age at first use in 2014 represents a real change or if this average in 2014 is an anomaly.

By Age Group

In 2014, an estimated 13,000 adolescents aged 12 to 17, 75,000 young adults aged 18 to 25, and 124,000 adults aged 26 or older used heroin for the first time in the past year (Figure 21). The number of adolescents in 2014 who were recent heroin initiates was similar to the numbers in most years between 2002 and 2013. There also were no significant variations in the number of heroin initiates across years for young adults. The number of heroin initiates aged 26 or older in 2014 was higher than the numbers in most years between 2002 and 2013. Data from future years would be useful for evaluating whether the higher number of initiates aged 12 or older in 2014 represents a real change or if this number in 2014 is an anomaly. Caution also is advised in interpreting the fluctuations in numbers of heroin initiates aged 26 or older in 2006 and 2009. In 2006 and 2009, only 0.2 percent of adults aged 26 or older in 2006 and 2009 used heroin in the past year, including adults who were not recent initiates.28 Therefore, the fluctuations in 2006 and 2009 are likely to reflect single-year anomalies.

Initiation of Hallucinogen Use

In 2014, there were 936,000 people aged 12 or older who had used hallucinogens for the first time in the past year (Figure 22).29 This averages to about 2,600 new hallucinogen users each day. The estimate for 2014 was similar to estimates in 2012 and 2013, but it was lower than the 2002, 2006, and 2008 to 2011 estimates.


Figure 22. Past Year Hallucinogen Initiates among People Aged 12 or Older, by Age Group (in millions): 2002-2014
Figure 22     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 22 Table. Past Year Hallucinogen Initiates among People Aged 12 or Older, by Age Group (in millions), and Mean Age at First Use of Hallucinogens among Past Year Hallucinogen Initiates Aged 12 to 49: 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   1.2+ 0.9 0.9 1.0   1.1+ 1.1   1.1+   1.3+   1.2+   1.1+ 1.1 1.1 0.9
12 to 17   0.5+   0.4+   0.4+   0.4+   0.4+   0.4+   0.5+   0.5+   0.5+   0.4+   0.4+ 0.3 0.3
18 to 25 0.6   0.4+   0.4+   0.5+ 0.6 0.5 0.6 0.7 0.7 0.6 0.6 0.6 0.6
26 or Older 0.1 0.0 0.1 0.1 0.2 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1
Mean Age at First Use 18.5 17.9+ 18.7 18.7 19.7 19.1 18.6 18.9 18.3+ 18.7 19.1 19.9 19.3

In 2014, the average age at first hallucinogen use among recent hallucinogen initiates aged 12 to 49 was 19.3 years. The average age at first use of hallucinogens in 2014 was similar to the average ages in most prior years between 2002 and 2013.

By Age Group

In 2014, an estimated 258,000 adolescents aged 12 to 17, 608,000 young adults aged 18 to 25, and 70,000 adults aged 26 or older used hallucinogens for the first time in the past year (Figure 22). The number of adolescents in 2014 who were recent hallucinogen initiates was lower than the numbers in 2002 to 2012, but there was no change from 2013. For young adults, the number of recent initiates in 2014 was greater than the numbers in 2003 to 2005, but it was similar to the numbers in 2002 and since 2006. The number of initiates aged 26 or older in 2014 was similar to the numbers between 2002 and 2013.

Initiation of LSD Use

There were 586,000 people aged 12 or older in 2014 who were past year initiates of LSD (Figure 13). On average, this represents roughly 1,600 people initiating LSD use each day. The number of past year LSD initiates in 2014 was higher than the numbers in 2002 to 2012, but it was similar to the number in 2013 (Figure 23). The data for numbers of recent LSD initiates are not discussed by age group because the numbers of initiates in some age groups in multiple years did not have sufficient precision.13


Figure 23. Past Year LSD Initiates among People Aged 12 or Older (in thousands): 2002-2014
Figure 23     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 23 Table. Past Year LSD Initiates among People Aged 12 or Older (in thousands), and Mean Age at First Use of LSD among Past Year LSD Initiates Aged 12 to 49: 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   338+   200+   235+   243+   265+   271+   400+   341+   381+   358+   421+ 482 586
Mean Age at First Use   17.4+   17.2+ 18.4 18.3 19.4   18.2+   18.4+   18.3+ 19.0   18.6+ 19.0 19.7 19.7

In 2014, the average age at first LSD use among recent initiates aged 12 to 49 was 19.7 years. The average age at first use of LSD in 2014 was greater than the averages in several earlier years (i.e., 2002, 2003, and 2007 to 2009), but it was similar to the averages in 2012 and 2013.

Initiation of Ecstasy Use

In 2014, there were 676,000 past year initiates of Ecstasy aged 12 or older in 2014 (Figure 13), which averages to about 1,900 people who initiated Ecstasy use each day. The number of initiates in 2014 was similar to the number in 2013, but it was lower than the numbers in several prior years (Figure 24). The number of past year initiates declined from 1.2 million in 2002 to 642,000 in 2003, increased to 1.1 million in 2009, then declined again in 2014.


Figure 24. Past Year Ecstasy Initiates among People Aged 12 or Older, by Age Group (in millions): 2002-2014
Figure 24     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 24 Table. Past Year Ecstasy Initiates among People Aged 12 or Older, by Age Group (in millions), and Mean Age at First Use of Ecstasy among Past Year Ecstasy Initiates Aged 12 to 49: 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   1.2+ 0.6 0.6 0.6   0.9+ 0.8   0.9+   1.1+   0.9+   0.9+   0.9+ 0.8 0.7
12 to 17   0.4+   0.2+   0.2+   0.2+   0.2+   0.2+   0.2+   0.3+   0.3+   0.3+   0.2+   0.2+ 0.1
18 to 25   0.6+   0.3+   0.3+   0.3+ 0.5 0.4 0.5   0.6+ 0.5 0.5 0.5 0.5 0.4
26 or Older   0.2+ 0.1 0.1 0.1 0.2 0.1 0.1 0.2 0.1 0.1 0.1 0.1 0.1
Mean Age at First Use 21.2 19.7 19.5 20.7 20.6 20.3 20.3 20.2 19.4+ 19.6+ 20.3 20.5 21.0

In 2014, the average age at first Ecstasy use among recent Ecstasy initiates aged 12 to 49 was 21.0 years. This average age at first use was fairly stable between 2002 and 2014.

By Age Group

In 2014, an estimated 125,000 adolescents aged 12 to 17, 448,000 young adults aged 18 to 25, and 104,000 adults aged 26 or older used Ecstasy for the first time in the past year (Figure 24). The number of recent adolescent initiates in 2014 was lower than the numbers in 2002 to 2013. The number of recent young adult initiates in 2014 was similar to the numbers in most years from 2006 to 2013, but it was greater than the numbers in 2003 to 2005. The number of recent Ecstasy initiates aged 26 or older in 2014 was similar to the numbers in 2003 to 2013.

Initiation of Inhalant Use

In 2014, there were 512,000 people aged 12 or older who had used inhalants for the first time within the past 12 months (Figure 13), which averages to about 1,400 people who initiated inhalant use each day. The number in 2014 was lower than the numbers in 2002 to 2011, but it was similar to the numbers in 2012 and 2013 (Figure 25).


Figure 25. Past Year Inhalant Initiates among People Aged 12 or Older, by Age Group (in thousands): 2002-2014
Figure 25     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 25 Table. Past Year Inhalant Initiates among People Aged 12 or Older, by Age Group (in thousands), and Mean Age at First Use of Inhalants among Past Year Inhalant Initiates Aged 12 to 49: 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   849+   871+   857+   877+   783+   777+   738+   822+   800+   719+ 584 563 512
12 to 17   591+   600+   603+   605+   571+   500+   494+   535+   516+   463+ 331 254 271
18 to 25   247+   247+   225+   240+ 191 201 221   235+   225+ 220 218 188 157
26 or Older     11+   24   29   32   22   76   23   53   58   37   36 121   84
Mean Age at First Use 15.9+ 16.0+ 16.0+ 16.1+ 15.7+ 17.1 15.9+ 16.9 16.3+ 16.4+ 16.9 19.2 18.2

In 2014, the average age at first inhalant use among recent inhalant initiates aged 12 to 49 was 18.2 years. This estimate was higher than the average ages in most years from 2002 to 2011, but it was similar to the average ages in 2012 and 2013.

By Age Group

In 2014, an estimated 271,000 adolescents aged 12 to 17 used inhalants for the first time in the past year (Figure 25). This averages to approximately 700 adolescents who initiated use of inhalants each day. The number of adolescents in 2014 who were recent initiates for inhalants was lower than the numbers in 2002 to 2011, but it was similar to the numbers in 2012 and 2013.

There were 157,000 young adults aged 18 to 25 in 2014 who initiated use of inhalants in the past year (Figure 25). The number of young adult initiates per year was fairly stable between 2006 and 2014. However, the number of young adult initiates in 2014 was lower than the numbers in 2002 to 2005 and in 2009 and 2010.

An estimated 84,000 adults aged 26 or older in 2014 used inhalants for the first time in the past year (Figure 25). The number of initiates aged 26 or older was fairly stable between 2003 and 2014.

Initiation of Alcohol Use

About 4.7 million people aged 12 or older in 2014 used alcohol for the first time within the past year (Figure 13). This averages to approximately 12,800 initiates per day. The number of initiates aged 12 or older was stable between 2006 and 2014, although the 2014 estimate was higher than the estimates in most years from 2002 to 2005 (Figure 26).


Figure 26. Past Year Alcohol Initiates among People Aged 12 or Older, by Age Group (in millions): 2002-2014
Figure 26     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 26 Table. Past Year Alcohol Initiates among People Aged 12 or Older, by Age Group (in millions), and Mean Age at First Use of Alcohol among Past Year Alcohol Initiates Aged 12 to 49: 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older   3.9+   4.1+ 4.4   4.3+ 4.4 4.6 4.5 4.6 4.7 4.7 4.6 4.6 4.7
12 to 17   2.6+   2.6+   2.7+   2.7+   2.7+   2.7+   2.6+   2.7+ 2.5   2.6+ 2.4 2.4 2.3
18 to 25   1.2+   1.4+   1.5+   1.4+   1.6+   1.7+   1.7+   1.8+ 2.0   2.0+   1.9+ 2.1 2.2
26 or Older 0.1 0.1 0.2 0.1 0.1 0.1 0.2 0.1 0.2 0.1 0.2 0.1 0.1
Mean Age at First Use 16.6+ 16.4+ 16.4+ 16.4+ 16.6+ 16.8+ 17.0 16.9+ 17.1 17.1 17.4 17.3 17.3

In 2014, the average age at first alcohol use among recent alcohol initiates aged 12 to 49 was 17.3 years. The average age at first use of alcohol was stable between 2010 and 2014, but the average age at initiation in 2014 was higher than the average ages in most years from 2002 through 2009. Nevertheless, in each year between 2002 and 2014, recent alcohol initiates on average first used alcohol in their late teens, well before the age of 21 (i.e., not counting sips from another person's drink).

By Age Group

In 2014, an estimated 2.3 million adolescents aged 12 to 17 used alcohol for the first time in the past year (Figure 26), which averages to approximately 6,400 adolescents initiating alcohol use each day. Also in 2014, 2.2 million young adults aged 18 to 25 and 95,000 adults aged 26 or older initiated alcohol use in the past year.

The number of adolescents in 2014 who recently initiated alcohol use was lower than the numbers in most years from 2002 to 2011, but it was similar to the numbers in 2012 and 2013 (Figure 26). In contrast, among young adults, the number of recent initiates in 2014 was higher than the numbers in most years from 2002 to 2012. For adults aged 26 or older, the number of initiates in 2014 was similar to the numbers from 2002 to 2013. These trend data for adults aged 26 or older consistently indicate that relatively few people start to use alcohol for the first time after the age of 25.

Initiation of Cigarette Use

In 2014, about 2.2 million people aged 12 or older smoked cigarettes for the first time within the past 12 months (Figure 13). This averages to about 5,900 new cigarette smokers every day. The number of initiates of cigarette use in 2014 who were aged 12 or older was similar to the numbers in 2011 to 2013 and in 2002 to 2005, but it was lower than the numbers in most years from 2006 to 2010 (Figure 27).


Figure 27. Past Year Cigarette Initiates among People Aged 12 or Older, by Age Group (in millions): 2002-2014
Figure 27     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 27 Table. Past Year Cigarette Initiates among People Aged 12 or Older, by Age Group (in millions), and Mean Age at First Use of Cigarettes among Past Year Cigarette Initiates Aged 12 to 49: 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older 1.9 2.0 2.1 2.3   2.5+ 2.2   2.5+   2.5+   2.4+ 2.4 2.3 2.1 2.2
12 to 17   1.2+   1.2+   1.3+   1.3+   1.3+   1.2+   1.3+   1.3+   1.2+   1.2+   1.0+ 0.9 0.8
18 to 25   0.6+   0.7+   0.8+   0.8+ 1.0   1.0+ 1.1 1.1 1.1 1.2 1.2 1.0 1.2
26 or Older 0.1 0.1   0.1+ 0.1 0.1   0.0+ 0.1 0.1 0.1 0.1 0.1 0.1 0.1
Mean Age at First Use 16.9+ 16.9+ 16.7+ 17.3+ 17.1+ 16.9+ 17.4+ 17.5+ 17.3+ 17.2+ 17.8+ 17.8+ 18.6

In 2014, the average age at first cigarette use among recent cigarette initiates aged 12 to 49 was 18.6 years. The average age at first use of cigarettes in 2014 was higher than in each year between 2002 and 2013. Data from future years would be useful for evaluating whether the higher average age at first use among recent cigarette initiates in 2014 represents a real change or if this average in 2014 is an anomaly.

By Age Group

In 2014, an estimated 838,000 adolescents aged 12 to 17 used cigarettes for the first time in the past year (Figure 27), which averages to approximately 2,300 adolescents each day who initiated cigarette use. Also, 1.2 million young adults aged 18 to 25 in 2014 initiated cigarette use in the past year, which translates to about 3,200 young adults each day who initiated cigarette use. Among adults aged 26 or older in 2014, 144,000 initiated cigarette use in the past year.

Among adolescents, the number of recent initiates of any cigarette use in 2014 was lower than the numbers in 2002 to 2012, although it was similar to 2013's number (Figure 27). There were about 1.2 million to 1.3 million new adolescent cigarette users each year from 2002 to 2011, but the number decreased to 1 million or below in subsequent years. Among young adults, the number of recent initiates of any cigarette use in 2014 was greater than the numbers in most years from 2002 to 2007, and it was similar to the numbers in subsequent years. The number of recent cigarette initiates in 2014 who were aged 26 or older was similar to the numbers in most years from 2002 to 2013. As was the case with alcohol initiation, these trend data for cigarettes consistently indicate that relatively few people initiate cigarette use after the age of 25.

Initiation of Smokeless Tobacco Use

About 1.0 million people aged 12 or older in 2014 initiated use of smokeless tobacco in the past year (Figure 13). This averages to about 2,800 people who initiated smokeless tobacco use each day. The number of smokeless tobacco initiates in 2014 was similar to the numbers in 2002 to 2005 and in 2012 and 2013, but it was lower than the numbers in 2006 through 2011 (Figure 28).


Figure 28. Past Year Smokeless Tobacco Initiates among People Aged 12 or Older, by Age Group (in millions): 2002-2014
Figure 28     D
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.

Figure 28 Table. Past Year Smokeless Tobacco Initiates among People Aged 12 or Older, by Age Group (in millions), and Mean Age at First Use of Smokeless Tobacco among Past Year Smokeless Tobacco Initiates Aged 12 to 49: 2002-2014
  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
+ Difference between this estimate and the 2014 estimate is statistically significant at the .05 level.
12 or Older 1.0 0.9 1.0 1.1   1.3+   1.3+   1.4+   1.5+   1.4+   1.3+ 1.0 1.1 1.0
12 to 17 0.5 0.5 0.4   0.5+   0.6+   0.6+   0.6+   0.7+   0.6+ 0.5 0.4 0.5 0.4
18 to 25 0.4   0.4+ 0.4 0.5 0.6   0.6+ 0.6   0.7+   0.7+   0.6+ 0.5 0.5 0.5
26 or Older 0.1 0.1 0.1 0.1 0.2 0.1 0.2 0.2 0.2 0.2 0.1 0.1 0.1
Mean Age at First Use 19.1 18.1 18.8 18.3 19.0 18.0+ 18.9 18.9 19.3 19.8 18.8 18.4 19.0

In 2014, the average age at first smokeless tobacco use among recent smokeless tobacco initiates aged 12 to 49 was 19.0 years. This average age was similar to the average ages in most years from 2002 to 2013.

By Age Group

In 2014, an estimated 431,000 adolescents aged 12 to 17 used smokeless tobacco for the first time in the past year (Figure 28), which averages to approximately 1,200 adolescents who initiated smokeless tobacco use each day. There were 468,000 young adults aged 18 to 25 in 2014 who initiated smokeless tobacco use in the past year, or about 1,300 new initiates each day. Among adults aged 26 or older in 2014, 117,000 initiated smokeless tobacco use in the past year.

The number of adolescents in 2014 who were recent smokeless tobacco initiates was lower than the numbers in 2005 to 2010, and it was similar to the numbers prior to 2005 and between 2011 and 2013 (Figure 28). The number of young adults in 2014 who were recent initiates was similar to the numbers in 2012 and 2013. However, the number of young adult initiates in 2014 was lower than the numbers in most years from 2007 to 2011, and it was greater than the number in 2003. The number of initiates in 2014 among adults aged 26 or older was similar to the numbers in each of the years between 2002 and 2013.



Author Affiliations


Rachel Lipari is with the Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, Rockville, MD. Larry A. Kroutil and Michael R. Pemberton are with RTI International (a registered trademark and a trade name of Research Triangle Institute), Research Triangle Park, NC.



Acknowledgments of Reviewers


The authors would like to thank Pradip Muhuri of the Center for Behavioral Health Statistics and Quality (CBHSQ), Substance Abuse and Mental Health Services Administration, for writing the substance use initiation portion of this report. In addition, the authors would like to thank Art Hughes and Neil Russell of CBHSQ, and Stephanie N. Barnett, Jennifer Cooney, Elizabeth A. P. Copello, Julia Gable, Erica Hirsch, Jeremy D. Porter, Ana Saravia, and Paxton Syrek at RTI International for reviewing previous drafts of this Data Review.



Endnotes


1 Wills, T. A., Vaccaro, D., McNamara, G., & Hirky, A. E. (1996). Escalated substance use: A longitudinal grouping analysis from early to middle adolescence. Journal of Abnormal Psychology, 105, 166-180. doi:10.1037/0021-843X.105.2.166

2 Pemberton, M. R., Porter, J. D., Hawkins, S. R., Muhuri, P. K., & Gfroerer, J. C. (2014). CBHSQ Data Review: The prevalence and influence of risk and protective factors on substance use among youths: National findings from the 2002 to 2008 National Surveys on Drug Use and Health. Rockville, MD: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality.

3 Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin, 112, 64-105. doi:10.1037/0033-2909.112.1.64

4 Robertson, E. B., David, S. L., & Rao, S. A. (2003, October). Preventing drug use among children and adolescents: A research-based guide for parents, educators, and community leaders (NIH Publication No. 04-4212[A], 2nd ed.). Retrieved from http://www.drugabuse.gov/publications/preventing-drug-abuse-among-children-adolescents/acknowledgments

5 Grant, B. F., & Dawson, D. A. (1997). Age at onset of alcohol use and its association with DSM-IV alcohol abuse and dependence: Results from the National Longitudinal Epidemiologic Survey. Journal of Substance Abuse, 9, 103-110. doi:10.1016/S0899-3289(97)90009-2

6 Chen, C. Y., Storr, C. L., & Anthony, J. C. (2009). Early-onset drug use and risk for drug dependence problems. Addictive Behaviors, 34, 319-322. doi:10.1016/j.addbeh.2008.10.021

7 McCabe, S. E., West, B. T., Morales, M., Cranford, J. A., & Boyd, C. J. (2007). Does early onset of non-medical use of prescription drugs predict subsequent prescription drug abuse and dependence? Results from a national study. Addiction, 102, 1920-1930. doi:10.1111/j.1360-0443.2007.02015.x

8 In this report, terms such as "Americans," "people in this country," "general population," or similar terms are used broadly to refer to the civilian, noninstitutionalized population that is covered by NSDUH. Although some people in the general population of the United States are outside of the civilian, noninstitutionalized population, information from the 2010 census suggests that the civilian, noninstitutionalized population includes at least 97 percent of the total U.S. population. See the following reference: Lofquist, D., Lugaila, T., O'Connell, M., & Feliz, S. (2012, April). Households and families: 2010 (C2010BR-14, 2010 Census Briefs). Retrieved from https://www.census.gov/prod/cen2010/briefs/c2010br-14.pdf

9 Details about the sample design, weighting, and interviewing results for the 2014 NSDUH are provided in Sections A.1, A.3.3, and B.3.1 of CBHSQ (2015). In particular, Tables A.1 and A.2 in CBHSQ (2015) provide sample design information on the targeted numbers of completed interviews by state and by age group, respectively. See the following reference: Center for Behavioral Health Statistics and Quality. (2015). 2014 National Survey on Drug Use and Health: Methodological summary and definitions. Retrieved from https://www.samhsa.gov/data/

10 The screening procedure involves listing all household members in order to determine whether zero, one, or two individuals aged 12 or older should be selected for the interview.

11 An overall response rate is not calculated for adolescents or adults because the screening response rate is not specific to age groups.

12 See the CBHSQ (2015) reference in endnote 9.

13 For a discussion of the criteria for suppressing (i.e., not publishing) unreliable estimates, see Section B.2.2 in CBHSQ (2015). See endnote 9 for the reference.

14 If the number of people in the population with a characteristic of interest has increased (e.g., the number of substance users) simply because the size of the overall population has increased, then the percentages will control for the increases both in the number of people with the characteristic of interest and the total number of people in the population.

15 The term "most years" is used when the 2014 estimate is either similar to or significantly different from the estimates in the majority of prior years. However, estimates may not follow the overall pattern in up to 3 nonsequential years for estimates that are available in 2002 to 2014 and in up to 1 or 2 nonsequential years for mental health estimates that are available in 2008 (or 2009) to 2014.

16 Anomalous differences between 2 years of data usually "correct" themselves with 1 or 2 additional years of data.

17 The questions included in the survey for the perceived risk from using different substances vary in terms of the frequency and quantity of use. For example, comparing perceptions of risk for alcohol and marijuana use is difficult because NSDUH respondents are asked about the perceived harm of having five or more drinks once or twice a week or of having four or five drinks nearly every day. In comparison, respondents are asked about the perceived risk from any use of marijuana on a monthly or weekly basis.

18 In NSDUH, a "drink" is defined as a can or bottle of beer, a glass of wine or a wine cooler, a shot of liquor, or a mixed drink with liquor in it. Times when respondents only had a sip or two from a drink are not considered to be alcohol consumption.

19 National Institute on Alcohol Abuse and Alcoholism. (2015). Rethinking drinking. Alcohol and your health. What are the risks? Retrieved from http://rethinkingdrinking.niaaa.nih.gov/WhatsTheHarm/WhatAreTheRisks.asp

20 Gillespie, N. A., Neale, M. C., & Kendler, K. S. (2009). Pathways to cannabis abuse: A multi-stage model from cannabis availability, cannabis initiation and progression to abuse. Addiction, 104, 430-438. doi:10.1111/j.1360-0443.2008.02456.x

21 Hopfer, C. (2014). Implications of marijuana legalization for adolescent substance use. Substance Abuse, 35, 331-335. doi:10.1080/08897077.2014.943386

22 In each year from 2002 to 2014, most missing data for perceived availability were accounted for by people not knowing how easy or difficult it would be to get a particular substance. Percentages of adults aged 18 to 25 and those aged 26 or older in 2014 who did not know how easy or difficult it would be to get different substances were similar to the percentages in most years from 2002 to 2013. However, youths aged 12 to 17 were more likely in 2014 not to know how easy or difficult it would be to get different substances than in most years from 2002 to 2011.

23 Estimates relating to the periods prior to the 12-month reference period have not been considered here because of concerns about their validity resulting from recall bias. See the following reference: Gfroerer, J., Hughes, A., Chromy, J., Heller, D., & Packer, L. (2004, July). Estimating trends in substance use based on reports of prior use in a cross-sectional survey. In S. B. Cohen & J. M. Lepkowski (Eds.), Eighth Conference on Health Survey Research Methods: Conference proceedings [Peachtree City, GA] (HHS Publication No. PHS 04-1013, pp. 29-34). Hyattsville, MD: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Health Statistics.

24 Numbers in Figure 13 refer to people who used a specific substance for the first time in the past year, regardless of whether the initiation of use of other substances occurred prior to the past year.

25 Nonmedical use of prescription drugs is defined as use of these drugs without a prescription of the individual's own or simply for the experience or feeling the drugs caused.

26 Past year initiates of methamphetamine use are counted as past year initiates for nonmedical use of stimulants only if they did not report previous nonmedical use of stimulants.

27 Past year initiates of crack cocaine use are counted as past year initiates for cocaine only if they did not report previous use of cocaine.

28 Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Retrieved from https://www.samhsa.gov/data/

29 Past year initiates of LSD, PCP, or Ecstasy use are counted as past year initiates for hallucinogens only if they had previously not used other hallucinogens.



Appendix A: Supplemental Tables of Estimates for Risk and Protective Factors and Initiation of Substance Use


Table A.1B – Perceived Risk of Harm Associated with Substance Use and Perceived Availability of Substances among Individuals Aged 12 or Older
Risk/Availability 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* Difference between estimate and 2014 estimate is statistically significant at the 0.05 level.
1 Respondents with unknown Perception of Risk data were excluded.
2 Respondents with unknown Perceived Availability data were excluded.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2014.
PERCEPTIONS OF GREAT RISK1                          
Cigarettes                          
Smoke One or More Packs per Day 71.1   (0.32) 71.4   (0.35) 74.3* (0.30) 74.4* (0.32) 73.8* (0.33) 73.8* (0.33) 73.5* (0.32) 71.0   (0.32) 71.4   (0.31) 71.3   (0.33) 71.6   (0.33) 70.9   (0.33) 71.2   (0.25)
Marijuana                          
Smoke Once a Month 38.3* (0.39) 39.6* (0.38) 39.7* (0.38) 38.3* (0.39) 39.3* (0.38) 38.3* (0.39) 36.9* (0.38) 34.4* (0.39) 32.5* (0.37) 31.9* (0.39) 30.8* (0.36) 28.2* (0.39) 26.5   (0.28)
Smoke Once or Twice a Week 51.3* (0.38) 52.8* (0.37) 52.4* (0.38) 51.5* (0.37) 51.2* (0.37) 50.9* (0.38) 48.7* (0.38) 45.7* (0.40) 43.2* (0.39) 42.3* (0.38) 40.3* (0.38) 37.1* (0.41) 34.3   (0.32)
Cocaine                          
Use Once a Month 71.5* (0.33) 71.0* (0.32) 70.8* (0.31) 71.1* (0.31) 71.1* (0.31) 71.5* (0.32) 70.1* (0.33) 70.4* (0.32) 70.2* (0.32) 69.4   (0.33) 70.5* (0.31) 69.2   (0.33) 68.6   (0.29)
Use Once or Twice a Week 89.4* (0.21) 89.0* (0.23) 89.0* (0.21) 89.4* (0.21) 88.8* (0.22) 89.1* (0.21) 88.6* (0.24) 87.9* (0.22) 88.0* (0.23) 87.5* (0.23) 87.9* (0.23) 87.3* (0.23) 86.3   (0.20)
Heroin                          
Try Once or Twice 82.4* (0.24) 82.2* (0.25) 81.3* (0.26) 81.8* (0.25) 82.2* (0.25) 81.9* (0.26) 81.8* (0.27) 81.9* (0.25) 81.8* (0.27) 82.0* (0.26) 82.6   (0.24) 82.2* (0.27) 83.1   (0.21)
Use Once or Twice a Week 93.9* (0.16) 93.9* (0.16) 93.7* (0.16) 93.8* (0.16) 93.8* (0.16) 93.9* (0.15) 93.6   (0.17) 93.6   (0.16) 93.4   (0.18) 93.4   (0.17) 93.4   (0.16) 93.3   (0.17) 93.3   (0.14)
LSD                          
Try Once or Twice 73.7* (0.30) 73.4* (0.31) 72.1* (0.33) 72.8* (0.32) 72.3* (0.31) 72.2* (0.33) 70.8* (0.32) 71.0* (0.33) 70.1* (0.34) 70.3* (0.34) 70.1* (0.33) 68.7   (0.34) 68.0   (0.29)
Use Once or Twice a Week 88.8* (0.21) 88.7* (0.21) 88.8* (0.21) 88.8* (0.23) 88.5* (0.20) 88.5* (0.22) 87.7* (0.22) 86.9* (0.24) 86.3* (0.25) 86.1* (0.25) 85.9* (0.23) 85.0* (0.25) 83.9   (0.21)
Alcohol                          
Have Four or Five Drinks Nearly
    Every Day
69.4* (0.33) 68.9* (0.33) 68.5* (0.33) 69.0* (0.33) 69.4* (0.32) 69.7* (0.33) 69.0* (0.34) 68.4* (0.34) 69.0* (0.32) 68.2* (0.34) 68.3* (0.34) 66.9   (0.34) 66.1   (0.28)
Have Five or More Drinks Once
    or Twice a Week
42.3* (0.37) 41.7* (0.35) 40.9   (0.36) 41.5* (0.37) 41.8* (0.36) 42.3* (0.37) 41.3* (0.38) 42.1* (0.36) 43.0* (0.39) 42.1* (0.37) 42.4* (0.36) 41.3* (0.37) 40.3   (0.31)
PERCEIVED AVAILABILITY2                          
Fairly or Very Easy to Obtain                          
Marijuana 58.0* (0.40) 58.8* (0.39) 57.5* (0.38) 57.3* (0.40) 57.1* (0.37) 57.4* (0.38) 56.0* (0.37) 56.2* (0.42) 57.1* (0.42) 57.5* (0.37) 57.5* (0.38) 58.6* (0.41) 60.2   (0.33)
Cocaine 31.8* (0.37) 31.8* (0.34) 31.4* (0.33) 30.8* (0.35) 31.2* (0.35) 30.6* (0.36) 29.3* (0.35) 28.3* (0.34) 26.7* (0.36) 26.5* (0.31) 25.5* (0.32) 24.0   (0.34) 24.4   (0.26)
Crack 29.5* (0.37) 30.0* (0.33) 29.3* (0.32) 29.0* (0.36) 29.0* (0.34) 28.7* (0.35) 26.8* (0.35) 25.6* (0.34) 24.4* (0.35) 23.7* (0.32) 22.7* (0.33) 21.2   (0.32) 21.7   (0.25)
Heroin 18.3* (0.30) 18.4* (0.29) 18.0* (0.27) 17.6* (0.29) 17.9* (0.28) 17.5   (0.30) 17.0   (0.30) 16.6   (0.29) 15.6* (0.28) 15.9* (0.26) 15.8* (0.28) 15.2* (0.29) 16.8   (0.23)
LSD 20.3* (0.30) 19.8* (0.27) 18.7* (0.27) 18.0* (0.29) 17.6* (0.26) 17.1* (0.28) 16.3* (0.29) 15.5* (0.26) 15.2* (0.27) 14.9* (0.24) 14.6   (0.25) 14.0   (0.26) 14.0   (0.21)
Approached in the Past Month by
    Someone Selling Drugs
  7.7* (0.15)   7.9* (0.16)   7.8* (0.16)   7.5* (0.15)   7.8* (0.16)   7.6* (0.17)   7.1* (0.15)   7.3* (0.16)   7.4* (0.17)   7.1* (0.14)   7.1* (0.15)   6.7   (0.16)   6.5   (0.13)
Table A.2B – Perceived Risk of Harm Associated with Substance Use and Perceived Availability of Substances among Youths Aged 12 to 17
Risk/Availability 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* Difference between estimate and 2014 estimate is statistically significant at the 0.05 level.
1 Respondents with unknown Perception of Risk data were excluded.
2 Respondents with unknown Perceived Availability data were excluded.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2014.
PERCEPTIONS OF GREAT RISK1                          
Cigarettes                          
Smoke One or More Packs per Day 63.1* (0.44) 64.2* (0.42) 67.5* (0.42) 68.3* (0.44) 68.7* (0.42) 68.8* (0.43) 69.5* (0.41) 65.5   (0.42) 65.3   (0.44) 66.2   (0.43) 65.7   (0.43) 64.3* (0.44) 66.3   (0.46)
Marijuana                          
Smoke Once a Month 32.4* (0.40) 34.9* (0.41) 35.0* (0.44) 34.0* (0.43) 34.6* (0.44) 34.4* (0.43) 33.4* (0.46) 30.3* (0.42) 29.6* (0.42) 27.6* (0.40) 26.5* (0.41) 24.2* (0.40) 22.9   (0.40)
Smoke Once or Twice a Week 51.5* (0.43) 54.4* (0.44) 54.7* (0.45) 55.0* (0.47) 54.2* (0.45) 54.6* (0.47) 52.8* (0.45) 49.0* (0.46) 47.2* (0.46) 44.8* (0.49) 43.6* (0.46) 39.5* (0.45) 37.4   (0.49)
Cocaine                          
Use Once a Month 50.5   (0.44) 51.4* (0.46) 49.6   (0.43) 48.8   (0.46) 49.0   (0.43) 49.6   (0.44) 49.4   (0.44) 49.2   (0.46) 49.1   (0.45) 48.1* (0.47) 50.4   (0.45) 49.3   (0.45) 49.8   (0.47)
Use Once or Twice a Week 79.8* (0.35) 80.7* (0.36) 79.8* (0.37) 79.9* (0.38) 79.2* (0.36) 78.9* (0.39) 79.1* (0.39) 78.4* (0.38) 78.3* (0.38) 78.1   (0.38) 78.9* (0.39) 78.4* (0.40) 77.2   (0.39)
Heroin                          
Try Once or Twice 58.5   (0.45) 58.8   (0.44) 57.0* (0.42) 56.5* (0.44) 57.2* (0.44) 56.9* (0.46) 57.4* (0.44) 56.7* (0.46) 57.4* (0.46) 56.6* (0.44) 57.3* (0.44) 58.2   (0.46) 59.2   (0.48)
Use Once or Twice a Week 82.5* (0.34) 82.6* (0.35) 81.4* (0.35) 81.8* (0.35) 81.2* (0.36) 81.0   (0.36) 81.3* (0.38) 80.9   (0.37) 80.4   (0.37) 79.7   (0.37) 80.0   (0.36) 79.8   (0.37) 79.9   (0.40)
LSD                          
Try Once or Twice 52.6* (0.46) 53.4* (0.46) 52.6* (0.44) 51.7* (0.48) 51.6* (0.44) 51.0* (0.47) 50.2* (0.45) 48.1* (0.46) 47.8* (0.49) 47.0   (0.47) 47.2   (0.45) 47.1   (0.47) 46.2   (0.50)
Use Once or Twice a Week 76.2* (0.39) 76.9* (0.41) 76.4* (0.36) 76.1* (0.39) 74.7* (0.39) 74.1* (0.41) 73.8* (0.42) 71.7* (0.43) 71.3* (0.43) 70.4* (0.44) 70.6* (0.42) 69.7* (0.45) 68.4   (0.47)
Alcohol                          
Have Four or Five Drinks Nearly
    Every Day
62.2   (0.48) 61.6   (0.45) 61.8   (0.45) 63.8* (0.43) 64.5* (0.43) 65.1* (0.43) 65.6* (0.44) 64.1* (0.44) 64.7* (0.43) 64.8* (0.46) 63.9* (0.42) 62.5   (0.43) 62.4   (0.49)
Have Five or More Drinks Once
    or Twice a Week
38.2   (0.43) 38.5   (0.42) 38.1   (0.40) 38.4   (0.47) 39.3   (0.43) 39.3   (0.45) 40.0   (0.45) 39.6   (0.42) 40.4   (0.45) 40.7* (0.49) 39.7   (0.45) 39.0   (0.45) 39.2   (0.47)
PERCEIVED AVAILABILITY2                          
Fairly or Very Easy to Obtain                          
Marijuana 55.0* (0.45) 53.6* (0.44) 52.2* (0.44) 51.0* (0.44) 50.1* (0.44) 49.2* (0.45) 49.4* (0.45) 50.0* (0.47) 48.9   (0.50) 47.7   (0.48) 47.8   (0.45) 48.6   (0.46) 47.8   (0.49)
Cocaine 25.0* (0.36) 25.0* (0.38) 24.4* (0.42) 24.9* (0.41) 25.9* (0.40) 24.5* (0.40) 22.1* (0.39) 20.9* (0.38) 19.1* (0.37) 17.5* (0.33) 16.0* (0.37) 14.4   (0.33) 14.4   (0.35)
Crack 26.5* (0.37) 26.2* (0.38) 25.0* (0.41) 25.3* (0.39) 26.2* (0.41) 25.3* (0.39) 23.2* (0.40) 22.1* (0.40) 20.1* (0.38) 18.2* (0.34) 16.7* (0.35) 14.9   (0.34) 14.3   (0.35)
Heroin 15.8* (0.31) 15.3* (0.33) 14.0* (0.33) 14.0* (0.31) 14.4* (0.32) 14.2* (0.31) 12.9* (0.31) 12.8* (0.32) 11.6* (0.30) 10.7* (0.28)   9.9   (0.30)   9.1   (0.28)   9.4   (0.29)
LSD 19.4* (0.34) 17.6* (0.36) 16.9* (0.35) 15.7* (0.33) 14.0* (0.32) 14.4* (0.31) 13.7* (0.32) 13.4* (0.31) 13.0* (0.32) 12.2   (0.29) 11.5   (0.29) 11.3   (0.30) 11.6   (0.33)
Approached in the Past Month by
    Someone Selling Drugs
16.7* (0.33) 16.1* (0.33) 16.3* (0.34) 15.5* (0.34) 15.3* (0.30) 14.5* (0.31) 13.8* (0.32) 14.4* (0.32) 14.3* (0.33) 13.8* (0.32) 13.2* (0.31) 12.4   (0.32) 12.1   (0.35)
Table A.3B – Perceived Risk of Harm Associated with Substance Use and Perceived Availability of Substances among Young Adults Aged 18 to 25
Risk/Availability 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* Difference between estimate and 2014 estimate is statistically significant at the 0.05 level.
1 Respondents with unknown Perception of Risk data were excluded.
2 Respondents with unknown Perceived Availability data were excluded.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2014.
PERCEPTIONS OF GREAT RISK1                          
Cigarettes                          
Smoke One or More Packs per Day 65.2* (0.45) 65.7   (0.44) 69.8* (0.42) 69.8* (0.41) 70.6* (0.42) 70.7* (0.41) 68.8* (0.44) 64.8* (0.44) 65.5* (0.43) 65.9   (0.45) 66.6   (0.43) 66.0   (0.43) 66.9   (0.46)
Marijuana                          
Smoke Once a Month 23.5* (0.42) 24.8* (0.39) 25.6* (0.43) 24.4* (0.41) 24.4* (0.39) 24.7* (0.44) 22.7* (0.39) 19.9* (0.40) 18.5* (0.38) 18.0* (0.39) 16.7* (0.37) 14.9* (0.35) 13.5   (0.35)
Smoke Once or Twice a Week 35.5* (0.48) 36.8* (0.48) 38.1* (0.47) 37.0* (0.48) 35.9* (0.47) 35.8* (0.47) 33.1* (0.44) 28.6* (0.45) 27.0* (0.43) 25.6* (0.46) 23.5* (0.42) 21.0* (0.41) 18.3   (0.40)
Cocaine                          
Use Once a Month 64.1   (0.45) 63.6   (0.42) 62.6   (0.43) 62.4   (0.45) 62.5   (0.47) 63.2   (0.45) 61.8   (0.43) 60.9* (0.47) 61.9   (0.47) 62.0   (0.47) 63.5   (0.45) 62.8   (0.47) 62.9   (0.52)
Use Once or Twice a Week 87.2* (0.28) 86.6* (0.31) 85.9* (0.33) 85.8* (0.33) 85.7* (0.31) 85.8* (0.32) 85.7* (0.31) 84.2   (0.34) 84.5   (0.35) 84.8   (0.33) 85.5* (0.32) 84.3   (0.33) 84.4   (0.37)
Heroin                          
Try Once or Twice 78.0* (0.36) 77.5* (0.38) 76.9* (0.37) 76.9* (0.38) 77.9* (0.36) 78.1* (0.38) 77.2* (0.36) 76.8* (0.40) 76.8* (0.39) 78.0* (0.37) 79.0* (0.36) 79.2   (0.37) 80.2   (0.42)
Use Once or Twice a Week 93.6   (0.24) 93.5   (0.24) 93.3   (0.24) 93.7   (0.24) 93.6   (0.23) 93.5   (0.22) 92.9   (0.24) 92.8* (0.24) 92.6* (0.24) 92.6* (0.24) 93.2   (0.23) 92.9   (0.23) 93.5   (0.25)
LSD                          
Try Once or Twice 62.4* (0.46) 63.0* (0.44) 62.6* (0.44) 62.1* (0.45) 63.3* (0.46) 63.5* (0.47) 61.2* (0.48) 60.0* (0.47) 59.3* (0.48) 60.1* (0.47) 59.1* (0.48) 57.9* (0.49) 56.4   (0.55)
Use Once or Twice a Week 84.8* (0.30) 85.3* (0.31) 85.7* (0.32) 85.5* (0.33) 84.9* (0.33) 84.9* (0.34) 83.3* (0.34) 81.5* (0.36) 80.6* (0.37) 80.4* (0.37) 80.0* (0.38) 77.5   (0.39) 77.3   (0.45)
Alcohol                          
Have Four or Five Drinks Nearly
    Every Day
62.1* (0.45) 61.1   (0.45) 61.7* (0.45) 61.8* (0.46) 62.2* (0.46) 62.4* (0.45) 62.9* (0.44) 61.8* (0.45) 62.0* (0.46) 62.0* (0.48) 61.4* (0.45) 59.8   (0.45) 60.0   (0.48)
Have Five or More Drinks Once
    or Twice a Week
33.2   (0.47) 31.9* (0.42) 31.5* (0.46) 32.7   (0.48) 32.6   (0.44) 33.2   (0.45) 33.0   (0.46) 33.2   (0.46) 33.7   (0.46) 34.5   (0.47) 34.5   (0.48) 33.2   (0.44) 33.5   (0.48)
PERCEIVED AVAILABILITY2                          
Fairly or Very Easy to Obtain                          
Marijuana 77.4* (0.43) 77.9* (0.38) 76.1   (0.44) 76.5* (0.41) 76.6* (0.42) 76.0   (0.43) 75.3   (0.43) 76.1* (0.41) 75.7   (0.41) 75.0   (0.43) 75.2   (0.43) 75.3   (0.45) 74.9   (0.47)
Cocaine 40.5* (0.45) 41.2* (0.47) 41.0* (0.47) 42.0* (0.46) 41.7* (0.49) 40.7* (0.48) 38.1* (0.44) 36.0* (0.46) 34.0* (0.47) 31.7* (0.42) 30.1* (0.44) 27.9   (0.44) 27.5   (0.47)
Crack 32.7* (0.44) 32.5* (0.47) 32.2* (0.43) 32.8* (0.45) 32.5* (0.46) 32.1* (0.46) 29.0* (0.44) 27.4* (0.42) 25.2* (0.43) 23.4* (0.40) 22.0* (0.39) 19.7   (0.38) 19.0   (0.41)
Heroin 20.3* (0.37) 20.2* (0.36) 19.2* (0.36) 19.1* (0.37) 19.1* (0.39) 18.9* (0.39) 17.9* (0.36) 16.9* (0.35) 16.9* (0.35) 15.3   (0.34) 15.7   (0.35) 15.1   (0.34) 15.0   (0.36)
LSD 28.9* (0.39) 26.7* (0.41) 23.7* (0.37) 22.7* (0.37) 21.2* (0.39) 20.2* (0.36) 19.5* (0.37) 18.6* (0.36) 18.6* (0.35) 17.9   (0.34) 17.5   (0.37) 16.9   (0.37) 17.1   (0.39)
Approached in the Past Month by
    Someone Selling Drugs
19.0* (0.35) 19.6* (0.37) 18.9* (0.38) 18.9* (0.36) 18.4* (0.37) 18.6* (0.36) 18.5* (0.37) 18.5* (0.36) 19.1* (0.37) 18.0* (0.34) 18.9* (0.38) 16.3   (0.35) 16.2   (0.41)
Table A.4B – Perceived Risk of Harm Associated with Substance Use and Perceived Availability of Substances among Adults Aged 26 or Older
Risk/Availability 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* Difference between estimate and 2014 estimate is statistically significant at the 0.05 level.
1 Respondents with unknown Perception of Risk data were excluded.
2 Respondents with unknown Perceived Availability data were excluded.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2014.
PERCEPTIONS OF GREAT RISK1                          
Cigarettes                          
Smoke One or More Packs per Day 73.3   (0.41) 73.4   (0.44) 75.9* (0.38) 76.1* (0.40) 75.0* (0.41) 75.0* (0.42) 74.8* (0.40) 72.8   (0.40) 73.2   (0.39) 72.8   (0.42) 73.2   (0.41) 72.5   (0.41) 72.6   (0.31)
Marijuana                          
Smoke Once a Month 41.7* (0.50) 42.9* (0.48) 42.9* (0.48) 41.3* (0.49) 42.5* (0.49) 41.1* (0.49) 39.8* (0.48) 37.5* (0.49) 35.4* (0.47) 34.9* (0.49) 33.8* (0.46) 31.0* (0.48) 29.2   (0.35)
Smoke Once or Twice a Week 54.1* (0.47) 55.4* (0.46) 54.7* (0.48) 53.6* (0.46) 53.5* (0.46) 53.0* (0.48) 50.9* (0.48) 48.2* (0.50) 45.6* (0.50) 44.9* (0.47) 42.9* (0.48) 39.6* (0.52) 36.6   (0.39)
Cocaine                          
Use Once a Month 75.7* (0.41) 75.0* (0.40) 75.2* (0.39) 75.7* (0.39) 75.6* (0.39) 75.8* (0.40) 74.2* (0.42) 74.7* (0.40) 74.3* (0.41) 73.4* (0.40) 74.2* (0.39) 72.8   (0.41) 71.9   (0.35)
Use Once or Twice a Week 91.1* (0.27) 90.6* (0.28) 90.8* (0.26) 91.3* (0.26) 90.7* (0.28) 91.0* (0.26) 90.3* (0.30) 89.7* (0.28) 89.8* (0.28) 89.2* (0.29) 89.4* (0.28) 89.0* (0.29) 87.8   (0.24)
Heroin                          
Try Once or Twice 86.5   (0.30) 86.2   (0.32) 85.3* (0.33) 86.1   (0.31) 86.3   (0.31) 85.9   (0.32) 85.8   (0.33) 85.9   (0.31) 85.7   (0.33) 85.9   (0.33) 86.3   (0.29) 85.7   (0.34) 86.5   (0.25)
Use Once or Twice a Week 95.5* (0.19) 95.5* (0.20) 95.5* (0.20) 95.5* (0.20) 95.5* (0.19) 95.6* (0.19) 95.3   (0.21) 95.4* (0.19) 95.2   (0.22) 95.2   (0.20) 95.1   (0.19) 95.1   (0.20) 94.8   (0.16)
LSD                          
Try Once or Twice 78.5* (0.38) 77.9* (0.39) 76.4* (0.40) 77.5* (0.39) 76.6* (0.38) 76.4* (0.41) 75.0* (0.40) 75.7* (0.40) 74.6* (0.42) 74.9* (0.42) 74.8* (0.40) 73.1   (0.42) 72.5   (0.34)
Use Once or Twice a Week 91.2* (0.26) 90.9* (0.26) 91.0* (0.26) 91.1* (0.28) 91.0* (0.25) 91.0* (0.27) 90.2* (0.27) 89.7* (0.29) 89.1* (0.31) 89.0* (0.31) 88.7* (0.28) 88.1* (0.31) 86.8   (0.25)
Alcohol                          
Have Four or Five Drinks Nearly
    Every Day
71.7* (0.43) 71.2* (0.42) 70.6* (0.43) 71.0* (0.41) 71.4* (0.41) 71.6* (0.41) 70.5* (0.44) 70.1* (0.44) 70.7* (0.41) 69.7* (0.43) 70.1* (0.42) 68.7* (0.43) 67.6   (0.34)
Have Five or More Drinks Once
    or Twice a Week
44.5* (0.47) 43.9* (0.45) 42.9* (0.46) 43.5* (0.47) 43.8* (0.46) 44.2* (0.46) 42.9* (0.48) 44.0* (0.45) 44.9* (0.48) 43.6* (0.47) 44.1* (0.45) 43.0* (0.47) 41.6   (0.38)
PERCEIVED AVAILABILITY2                          
Fairly or Very Easy to Obtain                          
Marijuana 54.9* (0.51) 56.0* (0.50) 54.9* (0.49) 54.7* (0.51) 54.6* (0.47) 55.2* (0.48) 53.5* (0.47) 53.4* (0.52) 54.8* (0.53) 55.6* (0.46) 55.5* (0.47) 56.9* (0.51) 59.2   (0.41)
Cocaine 31.3* (0.47) 31.1* (0.43) 30.6* (0.42) 29.6* (0.45) 30.0* (0.44) 29.6* (0.46) 28.7* (0.44) 27.8* (0.43) 26.3* (0.45) 26.7* (0.40) 25.9   (0.40) 24.5   (0.43) 25.2   (0.33)
Crack 29.4* (0.47) 30.1* (0.43) 29.4* (0.41) 28.8* (0.46) 28.8* (0.43) 28.5* (0.44) 26.8* (0.44) 25.7* (0.43) 24.8* (0.45) 24.5* (0.40) 23.6   (0.41) 22.2   (0.41) 23.1   (0.32)
Heroin 18.3   (0.39) 18.6   (0.38) 18.3   (0.35) 17.8   (0.37) 18.2   (0.35) 17.7   (0.38) 17.4   (0.38) 17.0* (0.37) 15.9* (0.35) 16.6* (0.33) 16.5* (0.35) 15.9* (0.37) 18.0   (0.29)
LSD 18.9* (0.38) 18.8* (0.35) 18.0* (0.34) 17.4* (0.37) 17.5* (0.33) 16.9* (0.36) 16.1* (0.37) 15.2* (0.34) 14.8* (0.34) 14.7* (0.31) 14.4   (0.32) 13.7   (0.33) 13.8   (0.26)
Approached in the Past Month by
    Someone Selling Drugs
  4.5   (0.18)   4.7* (0.18)   4.6   (0.19)   4.5   (0.17)   4.9* (0.19)   4.8* (0.20)   4.3   (0.17)   4.4   (0.18)   4.6   (0.20)   4.4   (0.17)   4.4   (0.16)   4.4   (0.18)   4.2   (0.13)
Table A.5B – Substance Use in the Past Month among Individuals Aged 12 or Older, by Age Group
Age/Substance 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
**Low precision; no estimate reported.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* Difference between estimate and 2014 estimate is statistically significant at the 0.05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2014.
Aged 12 or Older                          
Marijuana and Hashish   6.2* (0.14)   6.2* (0.14)   6.1* (0.15)   6.0* (0.15)   6.0* (0.15)   5.8* (0.14)   6.1* (0.15)   6.7* (0.16)   6.9* (0.16)   7.0* (0.16)   7.3* (0.17)   7.5* (0.17)   8.4   (0.16)
Cocaine   0.9* (0.05)   1.0* (0.06)   0.8* (0.05)   1.0* (0.06)   1.0* (0.06)   0.8* (0.06)   0.7* (0.05)   0.7   (0.05)   0.6   (0.04)   0.5   (0.04)   0.6   (0.05)   0.6   (0.05)   0.6   (0.04)
Heroin   0.1* (0.02)   0.1* (0.01)   0.1* (0.02)   0.1* (0.01)   0.1   (0.03)   0.1* (0.02)   0.1* (0.02)   0.1* (0.01)   0.1* (0.02)   0.1* (0.02)   0.1   (0.02)   0.1* (0.02)   0.2   (0.02)
LSD   0.0* (0.01)   0.1* (0.01)   0.1* (0.01)   0.0* (0.01)   0.1* (0.01)   0.1* (0.01)   0.1* (0.01)   0.1* (0.01)   0.1* (0.01)   0.1* (0.01)   0.1   (0.01)   0.1   (0.01)   0.1   (0.02)
Cigarettes 26.0* (0.34) 25.4* (0.33) 24.9* (0.32) 24.9* (0.32) 25.0* (0.33) 24.3* (0.33) 24.0* (0.32) 23.3* (0.32) 23.0* (0.31) 22.1* (0.32) 22.1* (0.32) 21.3   (0.30) 20.8   (0.26)
Alcohol 51.0* (0.42) 50.1* (0.39) 50.3* (0.40) 51.8   (0.40) 51.0* (0.39) 51.2* (0.41) 51.6* (0.39) 51.9   (0.38) 51.8   (0.39) 51.8   (0.39) 52.1   (0.39) 52.2   (0.41) 52.7   (0.33)
Binge Alcohol Use 22.9   (0.31) 22.6   (0.29) 22.8   (0.29) 22.7   (0.29) 23.0   (0.30) 23.3   (0.31) 23.4   (0.29) 23.7   (0.31) 23.1   (0.30) 22.6   (0.29) 23.0   (0.31) 22.9   (0.31) 23.0   (0.26)
Heavy Alcohol Use   6.7* (0.17)   6.8* (0.16)   6.9* (0.16)   6.6* (0.16)   6.9* (0.17)   6.9* (0.17)   7.0* (0.17)   6.8* (0.16)   6.7* (0.17)   6.2   (0.16)   6.5   (0.17)   6.3   (0.17)   6.2   (0.14)
Aged 12-17                          
Marijuana and Hashish   8.2* (0.24)   7.9   (0.24)   7.6   (0.23)   6.8   (0.22)   6.7* (0.21)   6.7   (0.22)   6.7   (0.22)   7.4   (0.24)   7.4   (0.25)   7.9   (0.24)   7.2   (0.22)   7.1   (0.23)   7.4   (0.27)
Cocaine   0.6* (0.07)   0.6* (0.06)   0.5* (0.06)   0.6* (0.06)   0.4* (0.05)   0.4* (0.05)   0.4* (0.05)   0.3   (0.05)   0.2   (0.05)   0.3   (0.05)   0.1   (0.03)   0.2   (0.04)   0.2   (0.04)
Heroin   0.0   (0.02)   0.1   (0.02)   0.1   (0.02)   0.1   (0.02)   0.1   (0.02)   0.0* (0.01)   0.1   (0.03)   0.1   (0.02)   0.0   (0.01)   0.1   (0.03)         ** (**)   0.1   (0.02)   0.1   (0.02)
LSD   0.2   (0.05)   0.2   (0.04)   0.2   (0.03)   0.1* (0.03)   0.1* (0.03)   0.1* (0.03)   0.2   (0.04)   0.1   (0.03)   0.2   (0.04)   0.1   (0.03)   0.1* (0.02)   0.2   (0.04)   0.3   (0.06)
Cigarettes 13.0* (0.30) 12.2* (0.29) 11.9* (0.30) 10.8* (0.28) 10.4* (0.26)   9.9* (0.27)   9.2* (0.25)   9.0* (0.26)   8.4* (0.26)   7.8* (0.24)   6.6* (0.22)   5.6* (0.20)   4.9   (0.21)
Alcohol 17.6* (0.32) 17.7* (0.33) 17.6* (0.32) 16.5* (0.32) 16.7* (0.32) 16.0* (0.34) 14.7* (0.32) 14.8* (0.32) 13.6* (0.33) 13.3* (0.31) 12.9* (0.31) 11.6   (0.29) 11.5   (0.33)
Binge Alcohol Use 10.7* (0.27) 10.6* (0.27) 11.1* (0.29)   9.9* (0.26) 10.3* (0.27)   9.7* (0.27)   8.9* (0.23)   8.9* (0.25)   7.9* (0.25)   7.4* (0.22)   7.2* (0.22)   6.2   (0.22)   6.1   (0.24)
Heavy Alcohol Use   2.5* (0.12)   2.6* (0.13)   2.7* (0.14)   2.4* (0.13)   2.4* (0.13)   2.3* (0.15)   2.0* (0.12)   2.1* (0.12)   1.7* (0.11)   1.5* (0.10)   1.3   (0.10)   1.2   (0.09)   1.0   (0.10)
Aged 18-25                          
Marijuana and Hashish 17.3* (0.36) 17.0* (0.37) 16.1* (0.37) 16.6* (0.37) 16.3* (0.35) 16.5* (0.37) 16.6* (0.37) 18.2* (0.38) 18.5   (0.38) 19.0   (0.39) 18.7   (0.39) 19.1   (0.39) 19.6   (0.45)
Cocaine   2.0* (0.12)   2.2* (0.13)   2.1* (0.13)   2.6* (0.15)   2.2* (0.13)   1.7* (0.12)   1.6   (0.12)   1.4   (0.11)   1.5   (0.11)   1.4   (0.12)   1.1   (0.09)   1.1   (0.10)   1.4   (0.11)
Heroin   0.1* (0.03)   0.1* (0.02)   0.1   (0.03)   0.2   (0.03)   0.2   (0.04)   0.1   (0.03)   0.2   (0.04)   0.2   (0.04)   0.3   (0.05)   0.3   (0.06)   0.4* (0.06)   0.3   (0.05)   0.2   (0.05)
LSD   0.1* (0.03)   0.2   (0.04)   0.3   (0.04)   0.2* (0.04)   0.2* (0.04)   0.2   (0.04)   0.3   (0.05)   0.3   (0.05)   0.3   (0.05)   0.3   (0.04)   0.3   (0.05)   0.3   (0.05)   0.3   (0.05)
Cigarettes 40.8* (0.48) 40.2* (0.47) 39.5* (0.49) 39.0* (0.47) 38.5* (0.48) 36.2* (0.49) 35.7* (0.45) 35.8* (0.48) 34.3* (0.47) 33.5* (0.47) 31.8* (0.47) 30.6* (0.46) 28.4   (0.53)
Alcohol 60.5   (0.53) 61.4* (0.50) 60.5   (0.51) 60.9   (0.51) 62.0* (0.51) 61.3* (0.52) 61.1* (0.49) 61.8* (0.52) 61.4* (0.50) 60.7   (0.54) 60.2   (0.49) 59.6   (0.53) 59.6   (0.56)
Binge Alcohol Use 40.9* (0.52) 41.6* (0.49) 41.2* (0.52) 41.9* (0.53) 42.3* (0.52) 41.9* (0.52) 41.2* (0.51) 41.8* (0.54) 40.5* (0.49) 39.8* (0.55) 39.5* (0.51) 37.9   (0.52) 37.7   (0.57)
Heavy Alcohol Use 14.9* (0.36) 15.1* (0.36) 15.1* (0.37) 15.3* (0.37) 15.6* (0.38) 14.8* (0.35) 14.6* (0.38) 13.8* (0.38) 13.5* (0.37) 12.1* (0.36) 12.7* (0.35) 11.3   (0.31) 10.8   (0.36)
Aged 26 or Older                          
Marijuana and Hashish   4.0* (0.16)   4.0* (0.16)   4.1* (0.17)   4.1* (0.17)   4.2* (0.17)   3.9* (0.16)   4.2* (0.18)   4.6* (0.18)   4.8* (0.19)   4.8* (0.19)   5.3* (0.20)   5.6* (0.20)   6.6   (0.18)
Cocaine   0.7* (0.07)   0.8* (0.08)   0.7* (0.06)   0.8* (0.07)   0.8* (0.08)   0.7* (0.08)   0.7* (0.06)   0.6   (0.07)   0.5   (0.05)   0.4   (0.05)   0.6   (0.07)   0.5   (0.06)   0.5   (0.05)
Heroin   0.1* (0.02)   0.0* (0.01)   0.1* (0.02)   0.0* (0.01)   0.1   (0.04)   0.1* (0.02)   0.1* (0.02)   0.1* (0.02)   0.1* (0.02)   0.1* (0.02)   0.1   (0.02)   0.1* (0.02)   0.2   (0.03)
LSD   0.0* (0.01)   0.0* (0.00)   0.0* (0.01)   0.0* (0.00)   0.0   (0.01)   0.0   (0.02)         ** (**)   0.0* (0.01)         ** (**)   0.0* (0.01)   0.0   (0.01)   0.0   (0.02)   0.1   (0.02)
Cigarettes 25.2* (0.42) 24.7* (0.41) 24.1* (0.39) 24.3* (0.39) 24.7* (0.40) 24.1* (0.40) 23.8* (0.41) 23.0* (0.39) 22.8* (0.38) 21.9   (0.39) 22.4   (0.40) 21.6   (0.38) 21.5   (0.32)
Alcohol 53.9* (0.53) 52.5* (0.49) 53.0* (0.51) 55.1* (0.51) 53.7* (0.49) 54.1* (0.52) 54.7* (0.50) 54.9* (0.48) 54.9* (0.48) 55.1* (0.49) 55.6   (0.48) 55.9   (0.50) 56.5   (0.39)
Binge Alcohol Use 21.4* (0.39) 21.0* (0.35) 21.1* (0.36) 21.0* (0.35) 21.4* (0.37) 22.0   (0.38) 22.2   (0.37) 22.4   (0.39) 21.9   (0.37) 21.6* (0.35) 22.1   (0.37) 22.4   (0.38) 22.5   (0.30)
Heavy Alcohol Use   5.9   (0.20)   5.9   (0.19)   6.1   (0.19)   5.6   (0.19)   6.0   (0.21)   6.1   (0.21)   6.3   (0.20)   6.2   (0.19)   6.1   (0.20)   5.7   (0.20)   6.1   (0.21)   6.1   (0.21)   6.0   (0.16)
Table A.6B – Youths Felt That Parents Would Strongly Disapprove of Substance Use Behaviors among Youths Aged 12 to 17
Behavior 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown Perceptions of Parents' Feelings data were excluded.
* Difference between estimate and 2014 estimate is statistically significant at the 0.05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2014.
Smoking One or More Packs of
    Cigarettes per Day
89.5* (0.26) 89.8* (0.28) 90.6* (0.28) 91.1* (0.26) 91.4* (0.24) 92.1* (0.25) 92.4* (0.23) 92.6* (0.23) 92.6* (0.24) 93.2   (0.22) 93.1   (0.22) 93.5   (0.23) 93.8   (0.25)
Trying Marijuana or Hashish Once
    or Twice
89.1* (0.29) 89.4* (0.28) 89.8* (0.28) 90.2* (0.26) 90.4* (0.26) 91.0* (0.26) 90.7* (0.26) 90.5* (0.27) 89.6* (0.29) 89.3* (0.28) 89.3* (0.27) 88.4* (0.28) 87.5   (0.34)
Using Marijuana or Hashish Once
    a Month or More
92.0* (0.24) 92.2* (0.22) 93.0* (0.23) 92.9* (0.23) 93.1* (0.22) 93.3* (0.22) 93.1* (0.23) 93.0* (0.23) 91.9* (0.26) 91.6* (0.24) 91.3* (0.25) 90.6   (0.26) 90.0   (0.31)
Having One or Two Drinks of an
    Alcoholic Beverage Nearly
    Every Day
89.0* (0.27) 88.5* (0.29) 89.0* (0.25) 88.9* (0.27) 89.6* (0.28) 89.6* (0.27) 89.7* (0.28) 90.3   (0.26) 90.5   (0.28) 90.5   (0.25) 90.5   (0.27) 90.7   (0.27) 90.6   (0.28)
Table A.7B – Youths Strongly Disapproved or Somewhat Disapproved of Peers' Substance Use Behaviors among Youths Aged 12 to 17
Behavior 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown Feelings about Peers data were excluded.
* Difference between estimate and 2014 estimate is statistically significant at the 0.05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2014.
Smoking One or More Packs of
    Cigarettes per Day
87.1* (0.30) 87.6* (0.27) 88.1* (0.29) 88.2* (0.29) 89.1* (0.28) 89.8* (0.27) 89.7* (0.28) 90.3* (0.26) 90.5* (0.28) 91.0* (0.26) 91.4* (0.26) 91.4* (0.27) 92.5   (0.25)
Trying Marijuana or Hashish Once
    or Twice
79.5   (0.35) 80.0   (0.35) 80.6* (0.35) 80.8* (0.37) 81.7* (0.35) 82.5* (0.34) 82.2* (0.35) 81.7* (0.35) 81.3* (0.38) 80.0   (0.36) 80.5   (0.36) 79.5   (0.38) 79.5   (0.41)
Using Marijuana or Hashish Once
    a Month or More
80.4* (0.35) 80.6* (0.35) 81.6* (0.34) 81.4* (0.36) 82.7* (0.33) 82.9* (0.34) 82.7* (0.34) 82.1* (0.36) 81.5* (0.37) 80.3* (0.37) 80.3* (0.35) 79.2   (0.37) 79.2   (0.42)
Having One or Two Drinks of an
    Alcoholic Beverage Nearly
    Every Day
84.7* (0.33) 84.4* (0.31) 85.0* (0.30) 85.6* (0.31) 86.4* (0.31) 86.6* (0.31) 87.1* (0.31) 87.5* (0.31) 88.1* (0.30) 88.1* (0.31) 88.7* (0.29) 88.7* (0.30) 89.7   (0.31)
Table A.8B – Exposure to Substance Use Prevention Program or Message in the Past Year among Youths Aged 12 to 17
Program/Message 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown Substance Use Program Participation or Prevention Message Exposure data were excluded.
* Difference between estimate and 2014 estimate is statistically significant at the 0.05 level.
1 Youths who did not report their school enrollment status or reported not being enrolled in school in the past 12 months were excluded from this analysis. Youths reporting that they were "home schooled" in the past 12 months were considered to be enrolled in school.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2014.
Participated in Alcohol, Tobacco, or
    Drug Prevention Program Outside of
    School
12.7* (0.28) 13.9* (0.32) 12.2* (0.30) 11.7   (0.29) 11.4   (0.29) 11.4   (0.30) 11.1   (0.29) 12.1* (0.29) 11.5   (0.28) 11.7   (0.29) 11.9* (0.29) 11.5   (0.29) 11.1   (0.30)
Saw or Heard Alcohol or Drug
    Prevention Message from Sources
    Outside School
83.2* (0.36) 83.6* (0.33) 83.0* (0.35) 81.1* (0.36) 79.3* (0.36) 77.8* (0.40) 77.9* (0.36) 76.9* (0.40) 75.9* (0.40) 75.1* (0.38) 75.9* (0.40) 72.6   (0.42) 72.9   (0.44)
Drug or Alcohol Prevention Messages
    Were Seen or Heard in School among
    Youths Enrolled in School1
78.8* (0.38) 78.1* (0.37) 78.2* (0.40) 77.9* (0.37) 76.9* (0.38) 75.8* (0.41) 76.1* (0.41) 75.2* (0.43) 75.7* (0.45) 74.6* (0.43) 75.0* (0.44) 73.5   (0.44) 73.0   (0.47)
Table A.9B – Past Month Substance Use among Youths Aged 12 to 17, by Exposure to Substance Use Prevention Program or Message in the Past Year
Program/Message/Substance 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown Prevention Programs and Messages Exposure data were excluded.
* Difference between estimate and 2014 estimate is statistically significant at the 0.05 level.
1 Youths who did not report their school enrollment status or reported not being enrolled in school in the past 12 months were excluded from this analysis. Youths reporting that they were "home schooled" in the past 12 months were considered to be enrolled in school.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2014.
Participated in Alcohol, Tobacco, or
    Drug Prevention Program Outside
    of School
                         
Illicit Drugs 11.1   (0.76) 10.9   (0.71) 11.0   (0.81)   8.7   (0.66)   8.9   (0.70)   9.4   (0.80)   8.8   (0.73) 10.4   (0.74)   9.5   (0.76) 10.8   (0.79)   9.5   (0.81)   8.9   (0.71)   9.4   (0.79)
Marijuana   7.1   (0.60)   6.8   (0.57)   7.9   (0.65)   5.8   (0.58)   6.1   (0.59)   6.2   (0.67)   5.7   (0.57)   6.8   (0.62)   6.9   (0.65)   7.5   (0.66)   6.7   (0.70)   7.0   (0.63)   7.0   (0.72)
Cigarettes 12.9* (0.79) 12.6* (0.70) 11.6* (0.76) 10.4* (0.79)   9.0* (0.73)   9.1* (0.70)   8.0* (0.70)   8.9* (0.67)   8.1* (0.68)   6.8* (0.62)   7.2* (0.69)   6.5* (0.62)   4.8   (0.57)
Binge Alcohol   8.7* (0.58) 10.4* (0.64)   9.5* (0.72)   8.5* (0.72)   9.8* (0.84)   7.9* (0.72)   7.5* (0.70)   8.0* (0.67)   7.3* (0.66)   6.9   (0.66)   7.8* (0.70)   5.2   (0.53)   5.4   (0.61)
Did Not Participate in Alcohol,
    Tobacco, or Drug Prevention
    Program Outside of School
                         
Illicit Drugs 11.7* (0.31) 11.3* (0.30) 10.5* (0.29) 10.0   (0.27)   9.9   (0.28)   9.5   (0.29)   9.2   (0.26) 10.0   (0.29) 10.1   (0.31)   9.9   (0.29)   9.5   (0.27)   8.7   (0.26)   9.3   (0.32)
Marijuana   8.3* (0.26)   8.1   (0.26)   7.5   (0.25)   6.9   (0.23)   6.7   (0.22)   6.7   (0.24)   6.7   (0.24)   7.4   (0.25)   7.4   (0.27)   7.9   (0.26)   7.3   (0.24)   7.0   (0.24)   7.3   (0.28)
Cigarettes 13.0* (0.32) 12.1* (0.32) 11.9* (0.32) 10.8* (0.30) 10.6* (0.28) 10.0* (0.28)   9.2* (0.26)   9.0* (0.28)   8.4* (0.27)   7.8* (0.26)   6.4* (0.23)   5.4* (0.21)   4.8   (0.22)
Binge Alcohol 11.0* (0.30) 10.7* (0.29) 11.3* (0.32) 10.1* (0.27) 10.4* (0.28) 10.0* (0.29)   9.0* (0.25)   9.0* (0.27)   7.9* (0.27)   7.5* (0.24)   7.1* (0.24)   6.3   (0.24)   6.1   (0.26)
Saw or Heard Alcohol or Drug
    Prevention Message from Sources
    Outside School
                         
Illicit Drugs 11.3* (0.31) 10.8* (0.27) 10.3* (0.30)   9.8   (0.28)   9.3   (0.29)   9.2   (0.30)   9.0   (0.28)   9.8   (0.30) 10.1* (0.32) 10.0   (0.31)   9.4   (0.29)   8.4   (0.29)   9.1   (0.35)
Marijuana   8.0* (0.26)   7.5   (0.26)   7.4   (0.24)   6.8   (0.25)   6.2* (0.23)   6.4   (0.24)   6.7   (0.25)   7.1   (0.26)   7.4   (0.27)   7.9   (0.28)   7.1   (0.25)   6.9   (0.26)   7.1   (0.32)
Cigarettes 12.5* (0.32) 11.5* (0.30) 11.5* (0.31) 10.3* (0.30)   9.6* (0.27)   9.6* (0.30)   8.9* (0.27)   8.8* (0.30)   7.8* (0.28)   7.2* (0.26)   6.2* (0.24)   5.2* (0.23)   4.5   (0.23)
Binge Alcohol 10.3* (0.28) 10.3* (0.29) 10.9* (0.32)   9.9* (0.29) 10.1* (0.29)   9.7* (0.30)   8.7* (0.26)   9.0* (0.29)   7.8* (0.28)   7.5* (0.26)   7.0* (0.25)   6.0   (0.25)   5.9   (0.29)
Did Not See or Hear Alcohol or Drug
    Prevention Message from Sources
    Outside School
                         
Illicit Drugs 13.2* (0.71) 13.7* (0.71) 11.8* (0.66) 10.4   (0.60) 12.0* (0.63) 10.7   (0.62) 10.2   (0.57) 11.3   (0.61)   9.9   (0.59) 10.2   (0.53) 10.0   (0.54) 10.0   (0.50)   9.9   (0.55)
Marijuana   8.8   (0.58) 10.0* (0.69)   8.2   (0.58)   7.1   (0.51)   8.5   (0.55)   7.5   (0.52)   6.5   (0.44)   8.3   (0.54)   7.3   (0.53)   7.7   (0.48)   7.6   (0.49)   7.7   (0.44)   7.8   (0.51)
Cigarettes 15.0* (0.71) 15.8* (0.76) 13.4* (0.73) 12.6* (0.68) 13.8* (0.67) 10.8* (0.56) 10.1* (0.54)   9.9* (0.54)   9.9* (0.55)   9.2* (0.53)   7.6* (0.46)   6.7   (0.42)   5.7   (0.42)
Binge Alcohol 12.5* (0.70) 12.5* (0.71) 12.0* (0.70) 10.3* (0.59) 11.5* (0.62) 10.0* (0.56)   9.6* (0.56)   8.7* (0.53)   7.9* (0.49)   7.0   (0.41)   7.9* (0.50)   6.8   (0.44)   6.4   (0.44)
Saw or Heard Drug or Alcohol
    Prevention Messages in School
    among Youths Enrolled in School1
                         
Illicit Drugs 10.9* (0.31) 10.4* (0.31) 10.0* (0.33)   9.2   (0.29)   8.9   (0.30)   8.7   (0.30)   8.5   (0.28)   9.2   (0.31)   9.3   (0.32)   9.2   (0.31)   8.9   (0.30)   8.4   (0.29)   8.5   (0.34)
Marijuana   8.0* (0.27)   7.4   (0.28)   7.1   (0.27)   6.4   (0.26)   6.0   (0.25)   6.1   (0.24)   6.1   (0.25)   6.7   (0.28)   6.9   (0.27)   7.2   (0.28)   6.7   (0.26)   6.7   (0.26)   6.6   (0.31)
Cigarettes 11.9* (0.32) 11.2* (0.32) 10.9* (0.34) 10.0* (0.32)   9.4* (0.29)   8.9* (0.30)   8.4* (0.27)   8.1* (0.30)   7.3* (0.29)   6.8* (0.27)   5.8* (0.24)   5.0* (0.23)   3.9   (0.22)
Binge Alcohol 10.0* (0.30) 10.1* (0.31) 10.5* (0.33)   9.6* (0.31)   9.8* (0.30)   9.0* (0.31)   8.4* (0.27)   8.4* (0.29)   7.1* (0.28)   7.4* (0.28)   7.0* (0.26)   5.8   (0.25)   5.4   (0.27)
Did Not See or Hear Drug or Alcohol
    Prevention Messages in School
    among Youths Enrolled in School1
                         
Illicit Drugs 14.6* (0.69) 14.8* (0.68) 13.6   (0.65) 13.2   (0.65) 13.3   (0.61) 12.1   (0.65) 12.3   (0.65) 12.9   (0.58) 12.6   (0.64) 13.2   (0.64) 12.3   (0.59) 10.2* (0.53) 12.3   (0.64)
Marijuana 10.1   (0.56) 11.1   (0.63) 10.6   (0.62)   9.1   (0.55) 10.0   (0.55)   9.2   (0.57)   9.2   (0.56)   9.9   (0.52)   9.6   (0.57) 10.8   (0.60)   9.7   (0.53)   8.7   (0.50)   9.9   (0.58)
Cigarettes 17.6* (0.76) 16.5* (0.73) 17.3* (0.79) 14.8* (0.65) 15.2* (0.64) 13.4* (0.66) 12.3* (0.61) 12.5* (0.59) 11.9* (0.61) 10.8* (0.56)   9.3* (0.51)   7.6   (0.45)   7.4   (0.51)
Binge Alcohol 14.2* (0.64) 14.0* (0.62) 14.7* (0.73) 12.7* (0.60) 13.3* (0.64) 12.8* (0.68) 11.6* (0.60) 11.3* (0.56) 10.8* (0.62)   8.4   (0.47)   8.7   (0.52)   8.0   (0.50)   7.9   (0.52)
Table A.10A – Past Year Initiation of Substance Use among Individuals Aged 12 or Older
Substance 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
NOTE: Estimates shown are numbers in thousands with standard errors included in parentheses.
* Difference between estimate and 2014 estimate is statistically significant at the 0.05 level.
1 Estimates in these designated rows do not include data from new methamphetamine initiation items added in 2007 or new methamphetamine use items added in 2005 and 2006.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2014.
ILLICIT DRUGS1 2,656*   (90) 2,627*   (99) 2,784   (100) 2,908   (139) 2,785   (102) 2,672*   (94) 2,905   (107) 3,136   (119) 2,982   (107) 3,083   (115) 2,883   (106) 2,848   (102) 3,011   (107)
Marijuana and Hashish 2,196*   (70) 1,973*   (70) 2,142*   (81) 2,114* (121) 2,061*   (79) 2,089*   (77) 2,224*   (89) 2,379     (79) 2,439     (93) 2,617     (97) 2,398     (96) 2,427     (86) 2,568     (95)
Cocaine 1,032*   (61)    986*   (56)    998*   (65)    872     (50)    977*   (60)    906     (57)    724     (52)    623     (47)    642     (57)    670     (48)    639     (48)    601*   (47)    766     (57)
Crack    337*   (44)    269*   (36)    215*   (29)    230*   (30)    243*   (31)    353*   (72)    209*   (34)      95     (15)      83     (20)      76     (14)      84     (16)      58     (13)    109     (24)
Heroin    117*   (20)      92*   (20)    118*   (28)    108*   (20)      90*   (15)    106*   (21)    116*   (23)    187     (30)    142     (24)    178     (26)    156     (23)    169     (36)    212     (35)
Hallucinogens 1,152*   (54)    886     (46)    934     (55)    953     (51) 1,118*   (72) 1,061     (60) 1,132*   (59) 1,276*   (66) 1,240*   (61) 1,137*   (58) 1,073     (58) 1,065     (72)    936     (58)
LSD    338*   (30)    200*   (20)    235*   (25)    243*   (29)    265*   (32)    271*   (23)    400*   (31)    341*   (28)    381*   (39)    358*   (30)    421*   (41)    482     (40)    586     (48)
PCP    123*   (15)    105*   (14)    106*   (20)      77*   (13)      70     (13)      58     (11)      53     (10)      45       (9)      46     (11)      48     (10)      90*   (21)      32       (7)      41     (10)
Ecstasy 1,206*   (68)    642     (44)    607     (47)    615     (46)    863*   (68)    777     (53)    892*   (58) 1,118*   (68)    949*   (56)    922*   (59)    869*   (60)    751     (50)    676     (52)
Inhalants    849*   (43)    871*   (44)    857*   (43)    877*   (47)    783*   (41)    777*   (47)    738*   (44)    822*   (48)    800*   (51)    719*   (47)    584     (42)    563     (51)    512     (49)
Nonmedical Use of
    Psychotherapeutics1
2,552* (108) 2,583* (110) 2,836* (120) 2,526* (111) 2,584* (110) 2,542* (117) 2,529* (105) 2,583* (121) 2,428* (113) 2,346   (118) 2,449* (124) 2,006   (100) 2,111     (99)
Pain Relievers 2,320* (107) 2,456* (109) 2,422* (100) 2,193* (102) 2,155*   (93) 2,159* (105) 2,189*   (94) 2,193* (100) 2,013*   (91) 1,888* (102) 1,880*   (99) 1,539     (82) 1,425     (76)
Tranquilizers 1,184     (80) 1,071     (64) 1,180     (74) 1,286     (88) 1,118     (68) 1,231     (82) 1,134     (73) 1,234     (95) 1,244     (86) 1,204     (90) 1,427* (115) 1,180     (89) 1,133     (73)
Stimulants1    783     (49)    715     (57)    793     (70)    647     (48)    846     (69)    640     (50)    602     (48)    710     (56)    626     (52)    670     (59)    676     (62)    603     (48)    690     (58)
Methamphetamine1    299*   (31)    260     (35)    318*   (35)    192     (21)    259     (42)    157     (20)      97*   (16)    155     (26)    107*   (16)    133     (20)    133     (27)    144     (21)    183     (31)
Sedatives    209     (33)    194     (38)    240     (43)    247     (40)    267     (46)    198     (29)    183     (32)    186     (29)    253     (46)    159     (29)    166     (29)    128     (27)    173     (25)
CIGARETTES 1,940     (75) 1,983     (72) 2,122     (72) 2,282     (86) 2,456*   (79) 2,231     (71) 2,453*   (90) 2,545*   (89) 2,403*   (81) 2,394     (86) 2,336     (89) 2,071     (81) 2,164     (90)
Daily Cigarette Use 1,016*   (64) 1,064*   (58) 1,101*   (55)    965*   (58) 1,049*   (54)    983*   (52)    945*   (57) 1,136*   (66)    962*   (57)    878     (55)    778     (53)    813     (52)    756     (51)
SMOKELESS TOBACCO    951     (52)    928     (50)    999     (53) 1,134     (58) 1,335*   (71) 1,299*   (61) 1,413*   (83) 1,468*   (67) 1,425*   (72) 1,297*   (75)    997     (53) 1,116     (65) 1,016     (59)
CIGARS 2,858   (103) 2,736     (99) 3,058* (112) 3,349* (113) 3,061* (104) 3,078* (107) 2,918* (105) 3,146* (121) 2,950* (120) 2,800   (143) 2,664   (108) 2,770   (144) 2,597   (104)
ALCOHOL 3,942* (101) 4,082* (104) 4,396   (127) 4,274* (108) 4,378   (107) 4,551   (111) 4,466   (116) 4,561   (112) 4,675   (131) 4,699   (124) 4,589   (130) 4,559   (113) 4,655   (127)
Table A.11A – Past Year Initiation of Substance Use among Youths Aged 12 to 17
Substance 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
NOTE: Estimates shown are numbers in thousands with standard errors included in parentheses.
* Difference between estimate and 2014 estimate is statistically significant at the 0.05 level.
1 Estimates in these designated rows do not include data from new methamphetamine initiation items added in 2007 or new methamphetamine use items added in 2005 and 2006.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2014.
ILLICIT DRUGS1 1,596* (52) 1,562* (51) 1,487   (51) 1,501   (50) 1,467   (52) 1,474   (50) 1,502   (54) 1,613* (53) 1,530   (53) 1,577* (52) 1,427   (52) 1,353   (50) 1,410   (58)
Marijuana and Hashish 1,373* (50) 1,219   (45) 1,252   (45) 1,139   (44) 1,194   (48) 1,168   (45) 1,248   (49) 1,343* (49) 1,274   (51) 1,375* (53) 1,255   (49) 1,200   (46) 1,203   (52)
Cocaine    310* (24)    282* (22)    274* (23)    286* (23)    260* (22)    254* (22)    196* (20)    145   (17)    156   (18)    146   (16)    120   (16)      94   (13)    117   (20)
Crack      86* (13)      76* (11)      42*   (9)      32*   (7)      41*   (8)      52* (10)      17     (5)      18     (5)      14     (4)      19     (5)      18     (8)      10     (4)      11     (5)
Heroin      39* (10)      25     (7)      31     (8)      18     (5)      24     (7)      16     (5)      29   (10)      19     (5)      23     (7)      38* (10)      21     (7)      21     (6)      13     (7)
Hallucinogens    474* (27)    417* (27)    437* (27)    398* (26)    397* (27)    397* (28)    469* (30)    462* (30)    498* (33)    419* (28)    358* (26)    306   (23)    258   (25)
LSD    180   (18)      96* (13)      99* (13)    105* (14)      76* (11)      97* (13)    147   (16)    106* (12)    100* (15)    123   (16)    125   (15)    122   (14)    165   (22)
PCP      77* (11)      59* (10)      43*   (9)      55* (11)      43* (10)      38*   (8)      37*   (7)      26     (7)      22     (6)      29     (7)      45* (11)      19     (6)      17     (6)
Ecstasy    350* (25)    219* (19)    225* (20)    183* (18)    207* (18)    242* (23)    246* (23)    311* (25)    324* (27)    300* (24)    201* (20)    182* (18)    125   (18)
Inhalants    591* (34)    600* (36)    603* (32)    605* (36)    571* (33)    500* (30)    494* (31)    535* (32)    516* (33)    463* (30)    331   (25)    254   (22)    271   (28)
Nonmedical Use of
    Psychotherapeutics1
   985* (42)    913* (39)    980* (42)    850* (37)    908* (40)    854* (39)    892* (42)    851* (41)    783* (39)    753* (35)    727   (35)    601   (34)    641   (40)
Pain Relievers    908* (42)    890* (41)    908* (42)    782* (36)    803* (37)    750* (36)    822* (40)    790* (39)    748* (39)    671* (32)    611* (32)    508   (31)    489   (34)
Tranquilizers    314   (25)    319   (24)    310   (22)    274   (21)    241   (20)    267   (23)    283   (22)    280   (20)    237   (21)    298   (25)    280   (26)    219   (19)    254   (25)
Stimulants1    341* (24)    292* (21)    271* (21)    264* (21)    296* (25)    224   (20)    196   (21)    196   (18)    190   (21)    169   (19)    183   (18)    138   (16)    183   (23)
Methamphetamine1    131* (16)    107* (14)      99* (13)      84   (12)      85   (13)      70   (12)      45   (11)      49   (10)      45     (9)      76   (14)      31     (7)      40     (8)      51   (13)
Sedatives      63   (11)      66   (11)      66   (10)      59   (10)      63     (9)      67   (12)      69   (11)      76   (12)      65   (12)      54   (10)      44     (8)      26*   (7)      59   (12)
CIGARETTES 1,187* (44) 1,226* (47) 1,294* (50) 1,303* (50) 1,333* (48) 1,198* (48) 1,288* (50) 1,273* (50) 1,205* (47) 1,165* (46) 1,032* (43)    932   (41)    838   (44)
Daily Cigarette Use    403* (27)    439* (27)    417* (32)    334* (24)    386* (27)    333* (23)    277* (23)    313* (24)    286* (24)    268* (22)    197   (22)    209   (19)    165   (19)
SMOKELESS TOBACCO    459   (27)    487   (27)    447   (29)    545* (34)    594* (31)    622* (36)    612* (34)    653* (33)    572* (33)    508   (31)    415   (27)    484   (34)    431   (30)
CIGARS 1,113* (40) 1,163* (46) 1,246* (48) 1,270* (47) 1,217* (42) 1,145* (44) 1,120* (43) 1,085* (43)    940* (40)    969* (41)    849   (38)    730   (36)    797   (41)
ALCOHOL 2,588* (64) 2,593* (65) 2,743* (73) 2,749* (69) 2,706* (68) 2,698* (69) 2,568* (64) 2,662* (69) 2,476   (62) 2,622* (69) 2,448   (72) 2,417   (67) 2,335   (67)
Table A.12A – Past Year Initiation of Substance Use among Young Adults Aged 18 to 25
Substance 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
NOTE: Estimates shown are numbers in thousands with standard errors included in parentheses.
* Difference between estimate and 2014 estimate is statistically significant at the 0.05 level.
1 Estimates in these designated rows do not include data from new methamphetamine initiation items added in 2007 or new methamphetamine use items added in 2005 and 2006.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2014.
ILLICIT DRUGS1    793* (41)    742* (39)    818* (41)    828* (47)    903* (53)    872* (47)    984   (53) 1,091   (58)    995   (51) 1,137   (60) 1,117   (59) 1,106   (57) 1,131   (63)
Marijuana and Hashish    733* (37)    666* (37)    714* (45)    723* (45)    742* (46)    787* (45)    817* (49)    988   (55)    918* (51) 1,060   (61)    966   (57) 1,017   (54) 1,094   (62)
Cocaine    594   (42)    576   (36)    592   (41)    498   (35)    570   (40)    541   (38)    426   (33)    397* (32)    372* (32)    467   (38)    443   (37)    432   (37)    501   (40)
Crack    100* (15)    109* (15)    120* (17)    142* (21)    132* (18)      88   (15)      91   (15)      62   (11)      39     (8)      40     (9)      49   (11)      25     (6)      54   (14)
Heroin      66   (13)      42     (9)      46   (10)      57   (13)      56   (12)      70   (14)      58   (11)      83   (13)      83   (15)    100   (17)      95   (16)      66   (13)      75   (15)
Hallucinogens    584   (35)    425* (33)    412* (32)    475* (32)    569   (40)    536   (35)    579   (39)    691   (46)    691   (45)    644   (42)    625   (42)    611   (44)    608   (47)
LSD    142* (18)      98* (14)    112* (16)    114* (16)    162* (22)    171* (18)    235* (23)    228* (25)    261* (33)    222* (23)    264* (33)    312   (31)    371   (37)
PCP      46   (11)      41     (9)      49   (14)      22     (6)      27     (8)      19     (7)      16     (6)      17     (6)      24     (9)      18     (8)      28     (8)      13     (5)      24     (8)
Ecstasy    613* (37)    337* (28)    303* (25)    322* (28)    495   (41)    410   (31)    523   (37)    611* (42)    543   (40)    501   (37)    543   (41)    494   (39)    448   (42)
Inhalants    247* (24)    247* (25)    225* (23)    240* (24)    191   (21)    201   (23)    221   (24)    235* (29)    225* (27)    220   (32)    218   (26)    188   (24)    157   (22)
Nonmedical Use of
    Psychotherapeutics1
   937   (42)    962   (47)    945   (46)    847   (43)    900   (48)    934   (50)    959   (50)    995   (52)    882   (48)    919   (50)    890   (53)    847   (53)    884   (55)
Pain Relievers    885* (45)    930* (46)    830* (43)    803* (43)    795* (46)    857* (50)    843* (46)    846* (48)    736* (43)    701* (44)    710* (43)    637   (48)    574   (45)
Tranquilizers    414   (33)    457   (32)    422   (31)    456   (35)    497   (32)    448   (34)    458   (31)    496   (37)    507   (40)    442   (33)    494   (39)    453   (36)    440   (36)
Stimulants1    337   (30)    240* (22)    344   (30)    276   (29)    310   (30)    276   (30)    282   (28)    351   (31)    327   (28)    315   (29)    332   (39)    345   (31)    356   (38)
Methamphetamine1    132* (20)      92   (14)    139* (19)      88   (14)    100   (17)      71   (14)      37   (10)      86   (16)      52   (11)      41   (10)      85   (22)      93   (16)      67   (14)
Sedatives      53   (10)      42     (8)      53   (11)      67   (14)      60   (11)      51   (10)      57   (14)      63   (14)      80   (14)      49   (13)      41   (10)      35     (9)      64   (13)
CIGARETTES    641* (40)    659* (45)    765* (46)    848* (46) 1,041   (52)    989* (48) 1,076   (58) 1,147   (60) 1,120   (54) 1,156   (59) 1,204   (65) 1,031   (57) 1,181   (72)
Daily Cigarette Use    447   (31)    474   (35)    566   (36)    493   (33)    554   (36)    566   (38)    549   (35)    618* (39)    599* (44)    525   (37)    488   (39)    505   (36)    479   (40)
SMOKELESS TOBACCO    396   (31)    353* (27)    432   (28)    506   (34)    568   (40)    597* (40)    583   (40)    664* (43)    652* (40)    599* (43)    496   (36)    514   (40)    468   (44)
CIGARS 1,031* (46) 1,055* (48) 1,199   (54) 1,332   (58) 1,275   (54) 1,379   (58) 1,277   (54) 1,417   (61) 1,388   (66) 1,238   (58) 1,291   (61) 1,334   (61) 1,311   (67)
ALCOHOL 1,230* (51) 1,430* (64) 1,484* (62) 1,421* (61) 1,612* (68) 1,741* (70) 1,706* (68) 1,775* (66) 2,008   (79) 1,971* (80) 1,945* (77) 2,056   (76) 2,225   (86)
Table A.13A – Past Year Initiation of Substance Use among Adults Aged 26 or Older
Substance 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
**Low precision; no estimate reported.
NOTE: Estimates shown are numbers in thousands with standard errors included in parentheses.
* Difference between estimate and 2014 estimate is statistically significant at the 0.05 level.
1 Estimates in these designated rows do not include data from new methamphetamine initiation items added in 2007 or new methamphetamine use items added in 2005 and 2006.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2014.
ILLICIT DRUGS1 268* (53) 324   (69) 479   (77) 579   (115) 415   (68) 326   (61) 419   (69) 433   (85) 457   (77) 368   (73) 339   (63) 389   (63) 469   (64)
Marijuana and Hashish   90* (25)   88* (30) 176   (47) 252   (97) 126* (33) 134* (37) 159   (45)   49* (15) 247   (60) 182   (49) 177   (53) 210   (44) 271   (45)
Cocaine 127   (33) 128   (36) 133   (39)   87   (23) 147   (38) 112   (32) 102   (34)   81   (28) 114   (41)   56* (22)   76   (26)   75   (29) 148   (35)
Crack 151* (38)   83   (31)   53   (21)   55   (19)   70   (24) 212* (69) 101   (30)   15   (10)   30   (18)   17   (9)   17   (8)   23   (11)   44   (18)
Heroin   12* (11)   25* (16)   40* (25)   33* (15)     9* (6)   20* (14)   28* (17)   85   (27)   37* (17)   40* (17)   40* (15)   82   (32) 124   (31)
Hallucinogens   93   (28)   44   (17)   85   (31)   80   (30) 152   (49) 128   (38)   85   (32) 123   (34)   51   (18)   75   (28)   90   (27) 147   (49)   70   (19)
LSD   16   (13)     ** (**)   24   (15)   24   (19)   28   (19)     ** (**)   18   (12)     ** (**)   20   (15)   13   (8)   33   (16)   48   (25)   50   (19)
PCP     ** (**)     ** (**)   14   (10)     ** (**)     ** (**)     ** (**)     ** (**)     ** (**)     ** (**)     ** (**)   17   (16)     ** (**)     ** (**)
Ecstasy 243* (50)   86   (27)   78   (29) 110   (33) 161   (48) 124   (35) 124   (36) 196   (43)   82   (24) 120   (40) 124   (37)   75   (26) 104   (23)
Inhalants   11* (8)   24   (13)   29   (13)   32   (15)   22   (12)   76   (26)   23   (11)   53   (24)   58   (27)   37   (17)   36   (18) 121   (39)   84   (34)
Nonmedical Use of
    Psychotherapeutics1
630   (84) 708   (91) 911* (100) 829* (96) 775   (91) 754   (99) 679   (81) 737   (100) 763   (91) 674   (92) 833* (103) 558   (78) 585   (69)
Pain Relievers 527   (82) 636* (92) 684* (79) 608* (84) 557* (73) 552   (85) 524   (71) 557* (77) 529   (69) 516   (84) 559* (77) 394   (61) 362   (53)
Tranquilizers 456   (67) 295   (52) 448   (62) 557   (78) 380   (56) 517   (71) 393   (60) 457   (86) 499   (73) 464   (76) 653   (102) 508   (80) 439   (59)
Stimulants1 106   (27) 183   (48) 178   (58) 108   (30) 239   (58) 140   (35) 124   (32) 163   (41) 108   (39) 185   (46) 160   (44) 121   (31) 152   (35)
Methamphetamine1   36   (16)   61   (29)   80   (26)   21   (11)   74   (36)   16* (9)   15* (8)   20   (17)   10* (8)   17* (10)   16   (15)   11* (11)   65   (22)
Sedatives   93   (30)   86   (35) 121   (39) 121   (37) 145* (44)   80   (24)   56   (26)   48   (22) 108   (42)   56   (24)   82   (26)   68   (25)   50   (18)
CIGARETTES 111   (36)   98   (31)   63* (20) 131   (40)   83   (30)   45* (15)   89   (31) 124   (35)   78   (24)   73   (25) 101   (28) 108   (32) 144   (29)
Daily Cigarette Use 166   (48) 150   (39) 118   (29) 137   (42) 109   (33)   84   (23) 119   (37) 204   (49)   77   (23)   85   (32)   92   (27)   99   (31) 113   (25)
SMOKELESS TOBACCO   95   (27)   88   (25) 121   (35)   83   (26) 174   (50)   80   (23) 219   (64) 152   (37) 202   (48) 190   (48)   85   (27) 118   (31) 117   (26)
CIGARS 714* (82) 518   (74) 614   (79) 747* (86) 570   (77) 555   (73) 521   (77) 644   (90) 622   (87) 593   (119) 524   (72) 706   (126) 489   (62)
ALCOHOL 124   (40)   60   (21) 169   (74) 105   (31)   60   (22) 112   (32) 193   (50) 124   (34) 191   (76) 106   (32) 196   (56)   85   (26)   95   (37)
Table A.14B – Mean Age at First Use among Past Year Initiates of Substance Use Aged 12 to 49
Substance 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
NOTE: Estimates shown are means with standard errors included in parentheses.
* Difference between estimate and 2014 estimate is statistically significant at the 0.05 level.
1 Estimates in these designated rows do not include data from new methamphetamine initiation items added in 2007 or new methamphetamine use items added in 2005 and 2006.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2014.
ILLICIT DRUGS1 17.9* (0.39) 17.5* (0.26) 18.1   (0.34) 18.7   (0.39) 19.0   (0.42) 18.0* (0.37) 18.8   (0.40) 17.6* (0.20) 19.1   (0.50) 18.1   (0.39) 18.7   (0.34) 19.0   (0.42) 19.0   (0.31)
Marijuana and Hashish 17.0* (0.19) 16.8* (0.14) 17.1* (0.21) 17.4* (0.22) 17.4* (0.21) 17.6* (0.34) 17.8   (0.35) 17.0* (0.13) 18.4   (0.48) 17.5* (0.18) 17.9   (0.32) 18.0   (0.26) 18.5   (0.28)
Cocaine 19.8* (0.33) 19.8* (0.36) 20.0* (0.45) 19.7* (0.38) 20.3* (0.51) 20.2* (0.52) 19.8* (0.44) 19.9* (0.42) 21.2   (0.96) 20.1* (0.47) 20.0* (0.32) 20.4* (0.36) 21.8   (0.48)
Crack 25.0   (1.35) 21.8   (1.01) 21.9   (1.35) 23.4   (1.28) 22.8   (1.47) 29.6   (2.54) 27.1   (1.68) 20.6* (0.66) 24.8   (2.45) 20.8   (1.05) 20.5   (1.03) 24.4   (2.70) 26.4   (2.78)
Heroin 21.0* (2.51) 20.9* (1.36) 24.4   (2.53) 22.2* (1.55) 20.7* (1.51) 21.8* (1.23) 23.5   (3.18) 25.3   (1.40) 21.4* (1.05) 22.1* (1.22) 23.0* (1.18) 24.5   (1.26) 28.0   (1.28)
Hallucinogens 18.5   (0.39) 17.9* (0.31) 18.7   (0.57) 18.7   (0.42) 19.7   (0.67) 19.1   (0.45) 18.6   (0.34) 18.9   (0.31) 18.3* (0.21) 18.7   (0.30) 19.1   (0.28) 19.9   (0.42) 19.3   (0.25)
LSD 17.4* (0.49) 17.2* (0.32) 18.4   (0.71) 18.3   (0.78) 19.4   (0.72) 18.2* (0.29) 18.4* (0.31) 18.3* (0.21) 19.0   (0.40) 18.6* (0.27) 19.0   (0.44) 19.7   (0.37) 19.7   (0.33)
PCP 16.0* (0.27) 17.4   (0.49) 18.9   (1.17) 16.5   (0.40) 16.3   (0.61) 16.4   (0.51) 15.9* (0.63) 16.8   (0.80) 17.6   (0.57) 17.8   (0.94) 16.6   (0.50) 17.1   (0.61) 17.7   (0.55)
Ecstasy 21.2   (0.63) 19.7   (0.50) 19.5   (0.61) 20.7   (0.73) 20.6   (0.76) 20.3   (0.57) 20.3   (0.61) 20.2   (0.39) 19.4* (0.44) 19.6* (0.44) 20.3   (0.42) 20.5   (0.58) 21.0   (0.47)
Inhalants 15.9* (0.17) 16.0* (0.26) 16.0* (0.29) 16.1* (0.34) 15.7* (0.24) 17.1   (0.54) 15.9* (0.25) 16.9   (0.67) 16.3* (0.35) 16.4* (0.33) 16.9   (0.32) 19.2   (0.95) 18.2   (0.80)
Nonmedical Use of
    Psychotherapeutics1
21.3   (0.50) 21.6   (0.48) 21.7   (0.40) 22.2   (0.52) 22.9   (0.56) 21.8   (0.52) 22.0   (0.51) 21.0   (0.42) 22.4   (0.56) 22.4   (0.60) 22.9   (0.54) 22.4   (0.64) 21.8   (0.40)
Pain Relievers 20.8   (0.50) 21.1   (0.45) 20.9   (0.42) 21.2   (0.47) 22.0   (0.57) 21.2   (0.45) 21.2   (0.48) 20.8   (0.45) 21.0   (0.45) 21.8   (0.72) 22.3   (0.58) 21.7   (0.62) 21.2   (0.48)
Tranquilizers 23.8   (0.69) 22.7   (0.77) 24.4   (0.75) 25.7* (0.84) 24.0   (0.62) 24.5   (0.67) 24.4   (0.77) 22.4   (0.63) 24.6   (0.74) 24.6   (0.83) 23.6   (0.55) 25.4   (0.98) 23.4   (0.55)
Stimulants1 19.2* (0.51) 21.5   (0.96) 20.0   (0.62) 20.1   (0.64) 23.0   (1.16) 21.9   (1.09) 21.3   (0.80) 21.5   (0.72) 21.2   (1.27) 22.2   (0.88) 22.1   (1.13) 21.6   (0.71) 21.6   (0.77)
Methamphetamine1 18.9* (0.66) 20.4   (1.04) 20.6   (0.83) 18.6* (0.73) 22.2   (2.14) 19.4   (1.18) 19.3   (0.90) 19.3   (0.94) 18.8* (0.81) 17.8* (0.86) 19.7   (0.79) 18.9* (0.63) 22.0   (1.07)
Sedatives 26.6   (2.34) 21.2   (2.43) 23.5   (1.89) 22.9   (1.58) 26.5* (1.78) 24.3   (1.54) 21.6   (1.75) 19.7   (1.02) 23.5   (2.01) 22.0   (1.83) 26.2* (2.02) 25.0   (1.73) 21.4   (1.30)
CIGARETTES 16.9* (0.30) 16.9* (0.26) 16.7* (0.19) 17.3* (0.33) 17.1* (0.21) 16.9* (0.12) 17.4* (0.26) 17.5* (0.25) 17.3* (0.21) 17.2* (0.13) 17.8* (0.23) 17.8* (0.22) 18.6   (0.23)
Daily Cigarette Use 19.9   (0.72) 19.8   (0.62) 18.8* (0.40) 19.7   (0.71) 18.9* (0.53) 19.2* (0.45) 20.1   (0.78) 20.7   (0.69) 19.1* (0.34) 19.1* (0.44) 19.9   (0.51) 19.8   (0.65) 20.6   (0.49)
SMOKELESS TOBACCO 19.1   (0.64) 18.1   (0.40) 18.8   (0.47) 18.3   (0.45) 19.0   (0.51) 18.0* (0.29) 18.9   (0.49) 18.9   (0.42) 19.3   (0.51) 19.8   (0.60) 18.8   (0.45) 18.4   (0.31) 19.0   (0.39)
CIGARS 21.8* (0.50) 20.3   (0.45) 20.2   (0.37) 21.2   (0.45) 19.9   (0.42) 20.5   (0.42) 20.0   (0.38) 20.7   (0.44) 20.5   (0.37) 19.6   (0.33) 20.5   (0.38) 21.6   (0.62) 20.4   (0.33)
ALCOHOL 16.6* (0.19) 16.4* (0.10) 16.4* (0.12) 16.4* (0.11) 16.6* (0.11) 16.8* (0.13) 17.0   (0.16) 16.9* (0.13) 17.1   (0.16) 17.1   (0.13) 17.4   (0.19) 17.3   (0.14) 17.3   (0.08)


Long Descriptions – Figures

Long description, Figure 1: Figure 1 is titled "Perceived Great Risk from Substance Use among People Aged 12 or Older: Percentages, 2014." It is a bar graph, where the percentage perceiving great risk is shown on the horizontal axis and the types of substance use are shown on the vertical axis.

The percentage of people aged 12 or older who perceived great risk from smoking marijuana once a month was 26.5 percent.

The percentage of people aged 12 or older who perceived great risk from smoking marijuana once or twice a week was 34.3 percent.

The percentage of people aged 12 or older who perceived great risk from using cocaine once a month was 68.6 percent.

The percentage of people aged 12 or older who perceived great risk from using cocaine once or twice a week was 86.3 percent.

The percentage of people aged 12 or older who perceived great risk from trying heroin once or twice was 83.1 percent.

The percentage of people aged 12 or older who perceived great risk from using heroin once or twice a week was 93.3 percent.

The percentage of people aged 12 or older who perceived great risk from trying LSD once or twice was 68.0 percent.

The percentage of people aged 12 or older who perceived great risk from using LSD once or twice a week was 83.9 percent.

The percentage of people aged 12 or older who perceived great risk from having five or more drinks of alcohol once or twice a week was 40.3 percent.

The percentage of people aged 12 or older who perceived great risk from having four or five drinks of alcohol nearly every day was 66.1 percent.

The percentage of people aged 12 or older who perceived great risk from smoking one or more packs of cigarettes per day was 71.2 percent.

Long description end. Return to Figure 1.

Long description, Figure 2: Figure 2 is titled "Perceived Great Risk from Smoking Marijuana Once a Month among People Aged 12 or Older, by Age Group: Percentages, 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the percentage perceiving great risk from smoking marijuana once a month is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing the percentage over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 2.

Long description, Figure 3: Figure 3 is titled "Perceived Great Risk from Using Cocaine Once a Month among People Aged 12 or Older, by Age Group: Percentages, 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the percentage perceiving great risk from using cocaine once a month is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing the percentage over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 3.

Long description, Figure 4: Figure 4 is titled "Perceived Great Risk from Trying Heroin Once or Twice among People Aged 12 or Older, by Age Group: Percentages, 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the percentage perceiving great risk from trying heroin once or twice is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing the percentage over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 4.

Long description, Figure 5: Figure 5 is titled "Perceived Great Risk from Trying LSD Once or Twice among People Aged 12 or Older, by Age Group: Percentages, 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the percentage perceiving great risk from trying LSD once or twice is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing the percentage over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 5.

Long description, Figure 6: Figure 6 is titled "Perceived Great Risk from Having Five or More Drinks of Alcohol Once or Twice a Week among People Aged 12 or Older, by Age Group: Percentages, 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the percentage perceiving great risk from having five or more drinks of alcohol once or twice a week is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing the percentage over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 6.

Long description, Figure 7: Figure 7 is titled "Perceived Great Risk from Smoking a Pack or More of Cigarettes a Day among People Aged 12 or Older, by Age Group: Percentages, 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the percentage perceiving great risk from smoking a pack or more of cigarettes a day as a great risk is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing the percentage over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 7.

Long description, Figure 8: Figure 8 is titled "Past Month Marijuana Use and Perceived Great Risk from Marijuana Use among People Aged 12 or Older: Percentages, 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the percentage for using marijuana or perceiving great risk from marijuana use is shown on the vertical axis. One line shows the percentage for past month marijuana use over the years 2002 through 2014. Also, two other lines show the percentage of people who perceived great risk from smoking marijuana once a month and the percentage who perceived great risk from smoking marijuana once or twice a week over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 8.

Long description, Figure 9: Figure 9 is titled "Past Month Binge Alcohol Use and Perceived Great Risk from Binge Alcohol Use among People Aged 12 or Older: Percentages, 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the percentage for binge alcohol use or perceiving great risk from binge alcohol use is shown on the vertical axis. One line shows the percentage for past month binge alcohol use over the years 2002 through 2014. Also, two other lines show the percentage of people who perceived great risk from having five or more drinks of alcohol once or twice a week and the percentage who perceived great risk from having four or five drinks of alcohol nearly every day over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. A note below the figure says, "For brevity, reference is made in the title to the perceived risk from binge alcohol use. However, consumption of four drinks on an occasion is slightly less than binge alcohol use as defined in NSDUH." An accessible table of the estimates in the line graph also is located below this figure.

Long description end. Return to Figure 9.

Long description, Figure 10: Figure 10 is titled "Past Month Cigarette Use and Perceived Great Risk from Cigarette Use among People Aged 12 or Older: Percentages, 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the percentage for cigarette use or perceiving great risk from cigarette use is shown on the vertical axis. One line shows the percentage for past month cigarette use over the years 2002 through 2014. A second line shows the percentage of people who perceived great risk from smoking one or more packs of cigarettes per day over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 10.

Long description, Figure 11: Figure 11 is titled "Perceived Availability of Substances among Youths Aged 12 to 17: Percentages, 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the percentage indicating it is fairly or very easy to obtain substances is shown on the vertical axis. For each of the four substances (marijuana, cocaine, heroin, and LSD), there is a line showing the percentage indicating it is fairly or very easy to obtain the substance over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. A note below the figure says, "Percent indicating substance was fairly or very easy to obtain." An accessible table of the estimates in the line graph also is located below this figure.

Long description end. Return to Figure 11.

Long description, Figure 12: Figure 12 is titled "Exposure to Substance Use Prevention Messages and Programs among Youths Aged 12 to 17: Percentages, 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the percentage seeing or hearing messages in the past year is shown on the vertical axis. One line shows the percentage of youths who had seen or heard drug or alcohol prevention messages from sources outside of school over the years 2002 through 2014. A second line shows the percentage of youths who had seen or heard drug or alcohol prevention messages at school over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 12.

Long description, Figure 13: Figure 13 is titled "Numbers of Past Year Initiates of Selected Substances among People Aged 12 or Older: 2014." It is a bar graph, where the number of past year initiates in millions is shown on the horizontal axis and 14 selected substances are shown on the vertical axis.

The number of past year initiates of marijuana among people aged 12 or older was 2,568,000 (2.6 million).

The number of past year initiates of the nonmedical use of pain relievers among people aged 12 or older was 1,425,000 (1.4 million).

The number of past year initiates of the nonmedical use of tranquilizers among people aged 12 or older was 1,133,000 (1.1 million).

The number of past year initiates of cocaine among people aged 12 or older was 766,000.

The number of past year initiates of the nonmedical use of stimulants among people aged 12 or older was 690,000.

The number of past year initiates of Ecstasy among people aged 12 or older was 676,000.

The number of past year initiates of LSD among people aged 12 or older was 586,000.

The number of past year initiates of inhalants among people aged 12 or older was 512,000.

The number of past year initiates of heroin among people aged 12 or older was 212,000.

The number of past year initiates of methamphetamine among people aged 12 or older was 183,000.

The number of past year initiates of the nonmedical use of sedatives among people aged 12 or older was 173,000.

The number of past year initiates of alcohol among people aged 12 or older was 4,655,000 (4.7 million).

The number of past year initiates of cigarettes among people aged 12 or older was 2,164,000 (2.2 million).

The number of past year initiates of smokeless tobacco among people aged 12 or older was 1,016,000 (1.0 million).

Long description end. Return to Figure 13.

Long description, Figure 14: Figure 14 is titled "Past Year Marijuana Initiates among People Aged 12 or Older, by Age Group (in millions): 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the number of past year initiates of marijuana in millions is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing initiates over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure. The table also includes data on the mean age at first use of marijuana among past year marijuana initiates aged 12 to 49 for the years 2002 to 2014.

Long description end. Return to Figure 14.

Long description, Figure 15: Figure 15 is titled "Past Year Pain Reliever Initiates among People Aged 12 or Older, by Age Group (in millions): 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the number of past year initiates of the nonmedical use of pain relievers in millions is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing initiates over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure. The table also includes data on the mean age at first nonmedical use of pain relievers among past year pain reliever initiates aged 12 to 49 for the years 2002 to 2014.

Long description end. Return to Figure 15.

Long description, Figure 16: Figure 16 is titled "Past Year Stimulant Initiates among People Aged 12 or Older, by Age Group (in thousands): 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the number of past year initiates of the nonmedical use of stimulants in thousands is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing initiates over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure. The table also includes data on the mean age at first nonmedical use of stimulants among past year stimulant initiates aged 12 to 49 for the years 2002 to 2014.

Long description end. Return to Figure 16.

Long description, Figure 17: Figure 17 is titled "Past Year Methamphetamine Initiates among People Aged 12 or Older, by Age Group (in thousands): 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and number of the past year initiates of methamphetamine in thousands is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing initiates over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure. The table also includes data on the mean age at first use of methamphetamine among past year methamphetamine initiates aged 12 to 49 for the years 2002 to 2014.

Long description end. Return to Figure 17.

Long description, Figure 18: Figure 18 is titled "Past Year Sedative Initiates among People Aged 12 or Older, by Age Group (in thousands): 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the number of past year initiates of the nonmedical use of sedatives in thousands is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing initiates over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure. The table also includes data on the mean age at first nonmedical use of sedatives among past year sedative initiates aged 12 to 49 for the years 2002 to 2014.

Long description end. Return to Figure 18.

Long description, Figure 19: Figure 19 is titled "Past Year Cocaine Initiates among People Aged 12 or Older, by Age Group (in millions): 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the number of past year initiates of cocaine in millions is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing initiates over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure. The table also includes data on the mean age at first use of cocaine among past year cocaine initiates aged 12 to 49 for the years 2002 to 2014.

Long description end. Return to Figure 19.

Long description, Figure 20: Figure 20 is titled "Past Year Crack Cocaine Initiates among People Aged 12 or Older, by Age Group (in thousands): 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the number of past year initiates of crack cocaine in thousands is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing initiates over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure. The table also includes data on the mean age at first use of crack cocaine among past year crack cocaine initiates aged 12 to 49 for the years 2002 to 2014.

Long description end. Return to Figure 20.

Long description, Figure 21: Figure 21 is titled "Past Year Heroin Initiates among People Aged 12 or Older, by Age Group (in thousands): 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the number of past year initiates of heroin in thousands is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing initiates over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure. The table also includes data on the mean age at first use of heroin among past year heroin initiates aged 12 to 49 for the years 2002 to 2014.

Long description end. Return to Figure 21.

Long description, Figure 22: Figure 22 is titled "Past Year Hallucinogen Initiates among People Aged 12 or Older, by Age Group (in millions): 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the number of past year initiates of hallucinogens in millions is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing initiates over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure. The table also includes data on the mean age at first use of hallucinogens among past year hallucinogen initiates aged 12 to 49 for the years 2002 to 2014.

Long description end. Return to Figure 22.

Long description, Figure 23: Figure 23 is titled "Past Year LSD Initiates among People Aged 12 or Older (in thousands): 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the number of past year initiates of LSD in thousands is shown on the vertical axis. There is a line showing initiates aged 12 or older over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure. The table also includes data on the mean age at first use of LSD among past year LSD initiates aged 12 to 49 for the years 2002 to 2014.

Long description end. Return to Figure 23.

Long description, Figure 24: Figure 24 is titled "Past Year Ecstasy Initiates among People Aged 12 or Older, by Age Group (in millions): 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the number of past year initiates of Ecstasy in millions is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing initiates over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure. The table also includes data on the mean age at first use of Ecstasy among past year Ecstasy initiates aged 12 to 49 for the years 2002 to 2014.

Long description end. Return to Figure 24.

Long description, Figure 25: Figure 25 is titled "Past Year Inhalant Initiates among People Aged 12 or Older, by Age Group (in thousands): 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the number of past year initiates of inhalants in thousands is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing initiates over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure. The table also includes data on the mean age at first use of inhalants among past year inhalant initiates aged 12 to 49 for the years 2002 to 2014.

Long description end. Return to Figure 25.

Long description, Figure 26: Figure 26 is titled "Past Year Alcohol Initiates among People Aged 12 or Older, by Age Group (in millions): 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the number of past year initiates of alcohol in millions is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing initiates over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure. The table also includes data on the mean age at first use of alcohol among past year alcohol initiates aged 12 to 49 for the years 2002 to 2014.

Long description end. Return to Figure 26.

Long description, Figure 27: Figure 27 is titled "Past Year Cigarette Initiates among People Aged 12 or Older, by Age Group (in millions): 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the number of past year initiates of cigarettes in millions is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing initiates over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure. The table also includes data on the mean age at first use of cigarettes among past year cigarette initiates aged 12 to 49 for the years 2002 to 2014.

Long description end. Return to Figure 27.

Long description, Figure 28: Figure 28 is titled "Past Year Smokeless Tobacco Initiates among People Aged 12 or Older, by Age Group (in millions): 2002-2014." It is a line graph, where the survey years are shown on the horizontal axis and the number of past year initiates of smokeless tobacco in millions is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing initiates over the years 2002 through 2014. Tests of statistical significance at the .05 level were performed between 2014 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure. The table also includes data on the mean age at first use of smokeless tobacco among past year smokeless tobacco initiates aged 12 to 49 for the years 2002 to 2014.

Long description end. Return to Figure 28.

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